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  • Form 4-06

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    Priscilla Bacungan
    40 vizualizări1 pagină
    The document appears to be a form from the Dangerous Drugs Board of the Philippines that drug companies must submit to report all transactions involving dangerous drugs or preparations over a given period. It requests information such as the beginning balance, quantities imported, manufactured, purchased, exported, sold, used as raw materials, surrendered, destroyed, and ending balance for each dangerous drug or preparation. The form notes that all columns must be filled out or marked as not applicable, and requires the signature of the company's authorized pharmacist to certify the report.

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    The document appears to be a form from the Dangerous Drugs Board of the Philippines that drug companies must submit to report all transactions involving dangerous drugs or preparations over a given period. It requests information such as the beginning balance, quantities imported, manufactured, purchased, exported, sold, used as raw materials, surrendered, destroyed, and ending balance for each dangerous drug or preparation. The form notes that all columns must be filled out or marked as not applicable, and requires the signature of the company's authorized pharmacist to certify the report.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    40 vizualizări1 pagină

    Form 4-06

    Încărcat de

    Priscilla Bacungan
    The document appears to be a form from the Dangerous Drugs Board of the Philippines that drug companies must submit to report all transactions involving dangerous drugs or preparations over a given period. It requests information such as the beginning balance, quantities imported, manufactured, purchased, exported, sold, used as raw materials, surrendered, destroyed, and ending balance for each dangerous drug or preparation. The form notes that all columns must be filled out or marked as not applicable, and requires the signature of the company's authorized pharmacist to certify the report.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 1

    DDB IDADIN Form 4-06 Republic of the Philippines

    Name of Company Office of the President


    Address DANGEROUS DRUGS BOARD
    S-License Number 3/F, DDB-PDEA Bldg, NIA Northsite Road, National Government Center
    Brgy Pinyahan, Quezon City

    Summary Report of Approved Transactions on Dangerous Drugs/Preparations


    (To be submitted by Importers/exporters/manufacturers and distributors of DD/preparations)
    For the period covering from ___________ to ___________

    Beg. Quantity Received Name of Quantity Disposed


    Name of Dangerous Balance Imported Locally Manufactured Others Total Supplier Exported Sold to Sold to Sold to Sold to Sold to Used as Raw Surrendered to Destroyed w/ prior Others Total
    Drugs/Preparations (Country Purchased (Country of Distributors Gov't Hospitals Private Drugstores Physicians Materials for PDEA approval from (e.g. loss) End
    (A) of Origin) (B) destination) Hospitals manufacture of PDEA & witnessed (give details) (C) Balance
    or Clinics DD preparations by PDEA Officers* (A+B-C)

    Note: Fill-out all columns. Indicate n/a if not applicable & nothing follows.

    CERTIFIED TRUE AND CORRECT:

    Printed Name/Signature
    of Company Authorized Pharmacist

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