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SR.

PRODUCT PACKING NEW


MRP MRP
TABLETS
1 TAB. ALCEF - O 100 5X10 82.00
Cefixime 100 mg. Alu/Alu
2 TAB. ALCEF - O 200 5X10 90.80 100.00
Cefixime 200 mg. Alu/Alu
3 TAB. ALCEF - O 200 LB 10X10 130.00 90
Cefixime 200 mg. +LacticAcid Bacilus 30 M.S Alu/Alu
4 TAB. ALCEF - OF 10X10 170.00
Cefixime 200 mg. + Ofloxacin 200 mg. Alu/Alu
5 TAB. ALCEF - CV 325 1X6 205.00
Cefixime 200 mg. + Clavulanic Acid 125 mg. Alu/Alu
6 TAB. ALCOX - 90 10X10 78.00
Etoricoxib 90 mg. Alu/Alu
7 TAB. ALCOX - P 10X10 78.00 86.00
Etoricoxib 60 mg. + Paracetamol 325 mg. Alu/Alu
8 TAB. ALCOSIDE - D 10X10 124.00 178.00
Diclofenac Sodium 50 mg. + Thiocolchicoside 4 mg. Alu/Alu
9 TAB. ALDOL - P 10X10 42.00 78.00
Tramadol 37.5 mg. + Paracetamol 325 mg.
10 TAB. ALEFEX - 120* 10X10 86.00
Fexofenadine-120mg Alu/Alu
11 TAB. ALIDE* 10X10 25.00
Nimesulide 100 mg. Mouth Dissolving Tablets
12 TAB. ALIDE - P 10X10 29.50
Nimesulide 100 mg. + Paracetamol 325 mg.
13 TAB. ALIDOM - C 10X10 60.00
Domperidone 15 mg. + Cinnarizine 20 mg.
14 TAB. ALPANT - 40 10X10 59.00 64.00
Pantoprazole 40mg Alu/Alu
15 TAB. ALPANT - D 10X10 Alu/Alu 68.00 72.00
Pantoprazole 40mg+Domperidone 10mg
16 TAB. ALPOD - 100 5X10 118.00
Cefpodoxime 100 mg. Alu/Alu
17 TAB. ALPOD - 200 5X10 218.00
Cefpodoxime 200 mg. Alu/Alu
18 TAB. ALPOD - CV 325 1X6 295.00 228.00
Cefpodoxime 200 mg. + Clavulanic Acid 125 mg. Alu/Alu
19 TAB. ALSERA - D* 10X10 62.00
Serratiopeptidase 10 mg. + Diclofenac Potassium 50 mg. Alu/Alu
20 TAB. ALSERA - DP 10X10 Alu/Alu 78.00
Serratiopeptidase 10 mg. + Diclofenac Potassium 50 mg. + Paracetamol 325 mg.
21 TAB. ALSERT - 50 10X10 52.00
Sertraline 50 mg. Alu/Alu
22 TAB. ALTRON - 5 10X10 57.20 54.00
Norethisterone 5 mg. Alu/Alu
23 TAB. ALTRIP 10X10 78.00 80.00
Trypsin & Chymotrypsin 100000 units Alu/Alu
24 TAB. AMLOTAR - AT 10X10 44.00
Amlodipine 5 mg. + Atenolol 50 mg. Alu/Alu
25 TAB. AXIFLO - 200 10X10 60.00
Ofloxacin 200 mg. Alu/Alu
26 TAB. AXIFLO - 400* 10X10 96.00
Ofloxacin 400 mg. Alu/Alu
27 TAB. AXIFLO - OZ 5X10 84.00
Ofloxacin 200mg. + Ornidazole 500mg. Alu/Alu
28 TAB. CALCITER 10X15 84.00
Calcium Citrate 1000 mg. + Vit. D3 200 i.u. + Zinc 4 mg. +Magnesium 100 mg.
29 TAB. CALCITER PLUS 5X10 Alu/Alu 98.00
Calcitrol 0.25 mcg. + Calcium Citrate 750 mg. + Zinc 7.5 mg + Magnesium 100 mg.
30 TAB. CEFLAR - 250* 10X10 67.50
Cephalexin 250 mg.
31 TAB. CETIZ 10X10 11.50
Cetirizine 10 mg.
32 TAB. DEFTAR - 6 10X10 82.00
Deflazacort 6 mg. Alu/Alu
33 TAB. DOXYTAR 10X10 Alu/Alu 62.00
Doxylamine Succinate 10 mg. + Pyridoxine HCL 10 mg. + Folic Acid 2.5 mg.
34 TAB. FERITER* 3X10 Alu/Alu 80.00
Sodium Feredetate 231 mg. + Folic Acid 1.5 mg. + Vit. B12 15 mcg
35 TAB. FERITER - S 3X10 110.00
Ferrous Ascorbate 100 mg. + Folic Acid 1.5 mg. Alu/Alu
36 TAB. FUZY - 150 20X1 12.00
Fluconazole 150 mg.
37 Tab. MECTAR 10X1 15.60 19.80
Albendazole 400 mg. + Ivermectin 6 mg.
38 Tab. ISOTER - 40 SR 10X10 63.00
Isoxsuprine -40 SR
39 TAB. MOXYTAR 10X10 45.00
Amoxycillin 250 mg. Dispersible
40 TAB. MOXYTAR - CV 228.5 10X10 95.00
Amoxycillin 200mg. + Clavulanic Acid 28.5 mg.
41 TAB. MOXYTAR - CV 625 1X6 113.30
Amoxycillin 500 mg. + Clavulanic Acid 125 mg. Alu/Alu 113.30
42 TAB. ORTHOTAR 3X10 Alu/Alu 136.00
Glucosamine 750 mg. + Diacerein 50 mg. + Methyl Sulphonyl Methane 250 mg.
43 TAB. SPASLIDE 10X10 28.00
Mefenamic Acid 250 mg. + Dicyclomine 10 mg.
44 TAB. SPASLIDE - D 10X10 52.00
Drotaverine HCL 80 mg.+ Mefenamic Acid 250 mg. Alu/Alu
45 TAB. T MAL-FORTE* 10x1x6 135.00
Artemether 80 mg +Lumefantrine 480 mg Alu/Alu
46 TAB.TELMITAR - 40 10X10 58.00 64.20
Telmisartan 40 mg. Alu/Alu
47 TAB.TELMITAR - H 10X10 66.00
Telmisartan 40 mg. + Hydrochlorothiazide 12.5 mg. Alu/Alu
48 TAB.TORNEX 10X10 44.00
Piroxicam 20 mg.
49 TAB. TORYL - GM 1 10X10 40.30
Glimepiride 1 mg. + Metformin 500 mg. (SR)
50 TAB. TORYL - GM 2 10X10 47.20
Glimepiride 2 mg. + Metformin 500 mg. (SR)
51 TAB. TRICET 10X10 31.00
Levocetirizine Dihydrochloride 5 mg. Alu/Alu
52 TAB. TRICET - M 10X10 125.00
Levocetirizine 5 mg. + Montelukast 10 mg. Alu/Alu
53 TAB. TROCEF - 250* 5X10 245.00
Cefuroxime 250 mg. Alu/Alu
54 TAB. TROCEF- 500 5X10 480.00
Cefuroxime 500 mg. Alu/Alu
55 TAB. TROCEF- 500 10X6 288.00
Cefuroxime 500 mg. Alu/Alu
56 TAB. TROFEN - MR 10X10 Alu/Alu 62.00
Aceclofenac 100 mg. + Paracetamol 325 mg. + Chlorzoxazone 250 mg.
57 TAB. TROFEN - P 10X10 38.00
Aceclofenac 100 mg. + Paracetamol 325 mg. Alu/Alu
58 TAB. TROFEN - SP 10X10Alu/Alu 78.00
Aceclofenac 100 mg. + Paracetamol 325 mg. + Serratiopeptidase 10 mg.
59 TAB. TROFEN - SR 10X10 36.00
Aceclofenac 200 mg. SR Alu/Alu
60 TAB. TROPY - 4 10X10 52.00
Methyl Prednisolone 4 mg. Alu/Alu
61 TAB. TROPY - 8 10X10 54.00
Methyl Prednisolone 8 mg. Alu/Alu
62 TAB. TROPY - 16 10X10 88.60
Methyl Prednisolone 16 mg. Alu/Alu
63 TAB. TROZITH-250 10X6 57.00 66.00
Azithromycin 250 mg.
64 TAB. TROZITH-500 10X3 56.10 66.00
Azithromycin 500 mg.
65 TAB. TROZY - 20 10X10 54.00
Rabeprazole 20 mg. Alu/Alu
66 TAB. TROZY - D 10X10 54.00 65.00
Rabeprazole 20 mg. + Domperidone 10 mg. Alu/Alu
67 TAB. VOLTAR - 250 10X10 44.80 46.30
Levofloxacin 250 mg. Alu/Alu
68 TAB. VOLTAR - 500 10X10 65.40 84.00
Levofloxacin 500 mg. Alu/Alu
69 TAB. ZOLEX - P* 10X10 36.00
Alprazolam 0.25 mg. + Propranalol 20 mg.
70 TAB. ZOLEX - S 10X10 49.00
Alprazolam 0.5 mg. + Sertraline 25 mg. Alu/Alu
CAPSUPS
71 CAP. ALCOVIT 3X10 Alu/Alu 130.00 164.00
Methylcobalamin 1500 mcg. + Alpha Lipoic Acid 100 mg. + Folic Acid 1.5 mg. + Pyridoxine 3 mg. + Thiamine 10 mg.
72 CAP. ALCOVIT PLUS 3X10 Alu/Alu 148.00
Methylcobalamin 1500 mcg. + Lycopene 5000 i.u. + Vit. A 25 i.u. + Vit. E 50 mg. + Spirulina 100 mg.
73 CAP. ALPANT - DSR 10X10 96.00
Pantoprazole 40 mg. + Domperidone 30 mg. Sustain Release . Alu/Alu
74 CAP. ALPINE 3X10 92.00
Lycopene + Lutein + Anti Oxidant + Multimineral Alu/Alu
75 CAP. BROPHY - 100* 10X10 86.00
Acebrophylline 100 mg. Alu/Alu
76 CAP. CALCITER-D3 10X4 109.50
Vitamin -D3 60000 I.U
77 CAP- CANDITAR-200 10x 4 164.00
Itraconazole BP-200mg Alu/Alu
78 CAP. CEFLAR - 500* 10X10 131.00
Cephalexin 500 mg.
79 CAP. MOXYTAR - 500 10X10 59.80 67.80
Amoxycillin 500 mg .
80 CAP- MEGATAR-4G 1*10 210.00
Omega-3 Fatty Acid,Green Tea Extract, Ginkgo Biloba, Ginseng, Grape Seeds
Extract,Vitamins & Minerals.
81 CAP. NERVIN - M 3X10 120.00
Pregabalin 75 mg. + Methylcobalamin 750 mcg. Alu/Alu
82 CAP. OMZIT 10X10 24.20
Omeprazole 20 mg. Alu/Alu
83 CAP. PROFIC 10X10 89.00
Pre & Probiotics . Alu/Alu
84 CAP. PROGY - 200 10X10 299.00
Naturual Micronised Progesterone 200 mg. Alu/Alu
85 CAP. TROZY - DSR 10X10 92.00
Rabeprazole Sod. 20 mg. + Domperidone 30 mg. SR Alu/Alu
86 CAP. TROZY - LS 10X10 138.00
Rabeprazole Sod.20 mg. & Levosulpiride 75 mg. SR . Alu/Alu
87 CAP. VITOMAC 3X10 78.00
Multivitamins + Antioxidant + Minerals. Alu/Alu
88 CAP. VITOMAC - X 3X10 Alu/Alu 98.00
Ginseng + Multivitamins + Antioxidant + Minerals . Alu/Alu
DRY SYRUPS
89 ALCEF - O 30ml. With WFI 46.00 45.60
Cefixime 50 mg./5 ml. Dry Syrup
90 ALPOD-50 30ml. With WFI 68.00 74.00
Cefpodoxime 50 mg./5 ml.
91 ALPOD-100 30ml. With WFI 120.00 128.00
Cefpodoxime 100 mg./5 ml.
92 ALPOD-CV 30ml. 88.00 98.00
Cefpodoxime 50 mg.+Clavulanic Acid31.25 mg /5 ml.
93 MOXYTAR - CV 30ml. 55.10 57.10
Amoxycillin 200 mg. + Clavulanic Acid 28.5 mg./ 5 ml.
SYRUPS
94 ALUGEL 170ml. 72.00
Magaldrate 400 mg. + Simethicone 20 mg./5 ml.
95 ALIDE - P 60ml. 36.00 40.00
Mefenamic Acid 50 mg. + Paracetamol 125 mg./5 ml.
96 ALIDE FORTE 60ml. 48.00 60.00
Mefenamic Acid 50 mg. + Paracetamol 250 mg./5 ml.
97 ALPINE 200ml. 128.00
Lycopene With Anti-Oxidants
98 ALPINE PLUS 200ml. 198.00
Lycopene With Metyhlcobalamin
99 AXIFLO* 30ml. 21.10
Ofloxacin 50 mg./5 ml.
100 BRONTER 60ml. 42.00 46.00
Ambroxol 15 mg. + Terbutaline 1.25 mg. + Guaiphenesin 50 mg. + Menthol 2.5 mg./ 5ml.
101 BRONTER 100ml. 78.00
Ambroxol 15 mg. + Terbutaline 1.25 mg. + Guaiphenesin 50 mg. + Menthol 2.5 mg./ 5ml.
102 BRONTER-LS 100ml. 84.00
Ambroxol 30 mg. + Guaiphenesin 50 mg. + Levosalbutamol Sulphate 1 mg/ 5ml.
103 CALCITER* 200ml. 74.00
Calcium Citrate + Magnesium + Zinc + Vitamin D3
104 ENZYTER 200ml. 94.00
Fungal Diastase (1:1200) IP18.75mg+Pepsin(1:3000) IP 12.5mg.
105 FERITER - S 200ml. 138.00
Sodium Feredetate 231 mg. + Folic Acid 1.5 mg. + Vit. B12 -5 mcg. /5 ml
106 HEPTIN PLUS 200ml. 84.00
Cyproheptadine + Tricholine Citrate + Sorbitol
107 LACTER* 100ml. 112.00
Lactulose 10 mg./15 ml.
108 SUCRATER - O 100ml. 125.00
Sucralfate 1 gm+ Oxetacaine 10 mg
109 TORCOX-DM 100ml. 78.00 -
Dmr Hbr 5mg. + Guaiphenesin 25mg. + CPM 2mg. + Amm.Chloride 60 mg+
Sodium Citrate 60mg. + Menthol 1 mg.
110 TRICET 30ml. 32.00
Levocetirizine 2.5 mg./5 ml.
111 TRICET - M 60ml. 64.00
Levocetirizine 2.5 mg.+Montelukast Sodium 4mg
112 TROFEN - P 60ml. 39.00 44.00
Aceclofenac 50 mg. + Paracetamol 125 mg.
113 TROLIV 200ml. 89.00
Liver Tonic
114 TROZITH -100 30ml 56.00
Azithromycin -100mg/ 5ml
115 TROZITH -200 30ml 81.00
Azithromycin -200mg/ 5ml
116 UTRON 200ml. 96.00
Gynecological Tonic
117 VITOMAC 200ml. 82.00
Multivitamin + Iron + L-Lysine + L-Glutamic Acid
118 VOMY 30ml. 34.20
Ondensetron 2 mg./5 ml.
INJECTABLES
119 INJ. ALCEF - 125 Vial With WFI 22.90
Ceftriaxone 125 mg .
120 INJ. ALCEF - 250 Vial With WFI 25.00 25.80
Ceftriaxone 250 mg .
121 INJ. ALCEF - 500 Vial With WFI 43.90 45.80
Ceftriaxone-500 mg .
122 INJ. ALCEF - 1000 Vial With WFI 51.30
Ceftriaxone 1000 mg.
123 INJ. ALCEF - S 375 Vial With WFI 48.00
Ceftriaxone 250 mg + Sulbactam 125 mg.
124 INJ. ALCEF - S 750 Vial With WFI 69.00
Ceftriaxone 500mg + Sulbactam 250mg.
125 INJ. ALCEF - S 1500 Vial With WFI 126.00
Ceftriaxone 1000 mg. + Sulbactam 500 mg.
126 INJ. ALCEF - TZ 1125 Vial With WFI 148.00
Ceftriaxone 1000 mg. + Tazobactam 125 mg.
127 INJ. ALCOVIT 5X2ml. 26.00
Methylcobalamin 1000 mcg
INJ. ALCOVIT PLUS 2ml. With Dispo 68.00
128
Methylcobalamin 1500 mcg.
INJ. ALCOVIT FORTE 2ml. With Dispo 75.00
129
Methylcobalamin 2500 mcg.
130 INJ. ALDOL - 100 10X2ml. 26.40
Tramadol 100 mg./2ml. I
131 INJ. ALITOB - 80 2ml 78.00
Tobramycin 80 mg./2ml
132 INJ. ALPANT WITH TRAY Vial 45.25 46.80
Pantoprazole 40 mg.
133 INJ. ALPANT W/O TRAY Vial 45.25 46.80
Pantoprazole 40 mg.
134 INJ. ALPIP - 4.5 Vial 461.70
Piperacillin 4gm. + Tazobactam 0. 5gm.
135 INJ. AMITAR - 100 2ml. Vial 24.00
Amikacin 100 mg .
136 INJ. AMITAR - 500 2ml. Vial 84.00
Amikacin 500 mg.
137 INJ. DICLOTAR* 10X3ml. 5.00
Diclofenac Sodium 25mg./ml.
138 INJ. DICLOTAR 5X5X1ml. 19.40
Diclofenac Sodium 75mg./ml.
139 INJ. FALCITAR* Vial 185.00
Artesunate 60 mg.
INJ. NEUDAC - 25 Amp. With 85.00
140 Dispo
Nandrolone Decanoate 25 mg.
INJ. NEUDAC - 50 Amp. With 142.00 158.00
141 Dispo
Nandrolone Decanoate 50 mg.
INJ. PROGY - 100* Amp. With 75.00
142 Dispo
Natural Progesterone 100 mg.
143 INJ. SLYTAR Amp. 24.00
Ethamsylate
144 INJ.TORNEX 5X2ml. 21.00 32.00
Piroxicam 20 mg.
145 INJ. T- MAL* 3X1ml. 48.00
Arteether 75 mg./ml.
146 INJ. T- MAL 3X2ml. 78.00
Arteether 75 mg./ml.
147 INJ. T- MAL* DISPO 3X1ml. 48.00
Arteether 75 mg./ml. Amp. With
Dispo
148 INJ. T- MAL* DISPO 3X2ml. 78.00
Arteether 75 mg./ml. Amp. With
Dispo
149 INJ TROPY-80 1*2ML 128.00
Methyl Prednisolone Acetate 80mg/2ml..
150 INJ. VOMY 1*2ML 11.40 11.85
Ondasetron 2mg/ml
TOPICAL RANGE
151 ALSCAB 100ml. 72.45 92.00
Gamma Benzene Hexachloride 1% w/w + Cetrimide 0.1% w/w Emulasion
152 CLOTER - N 10gm. 42.00
Beclomethasone Dip. 0.025%w/w + Neomycin0.5%w/w + Clotrimazole 1%w/w Oint.
153 FUCITER 10gm. 88.80 96.00
Fusidic Acid 2% w/w
154 FUCITER-B 10gm. 104.00
Fusidic Acid 2% w/w +Beclomethasone Dip.0.064%w/w
155 POVIT 15gm. 36.00
Povidine Iodine 5% w/w+Metronidazole1 %w/w+Dexpanthenol5%w/w Oint.
156 POVIT-0 20gm 48.00
Povidine Iodine 5% w/w+Ornidazole 1%w/w Oint.
157 SCATER* 60ml. 56.00
Permethrin 5% w/w Lotion
DROPS
158 Drop. ALMOX* 10ml. 68.00
Moxifloxacin 0.5% w/v
159 Drop. AXIFLO* 10ml. 23.00
Ofloxacin Eye Drop
160 Drop. NAZITAR 10ml. 50.60
Xylometazoline 0.1% w/w
161 Drop. NAZITAR - S 10ml. 42.00
Sodium Chloride IP 0.74%w/v+Benzalkonium Chloride 0.01% w/v.
OTHERS
162 ALGESIC-OIL 50ml. 84.00
Pain Reliever Herbal Oil
163 OINT. ALGESIC 30gm. 92.00
Diclofenac Diethylamine + Methyl Salicylate + Oleum Lini + Menthol +l Gel
164 SACHET PROFIC 1*25 SAC 14.80 15.80
Pre & Probiotics .
POW. ALPRO 200gm. Tin 192.00 220.00
165 Pack
Protein + Methylcobalamin + Vitamins
166 AXADIN MOUTH WASH 100ml. 56.00 74.00
Chlorhexidine Gluconate Solution 2% W/W
167 POW. ENRTER 210gm. 74.00
Enerzy Enhancer with Vitamin -C (Orange Flavaour)

BBANNED PRODUCTS
1 TAB. ALPOD - AZ 10X10 294.00
Cepodoxime 200 mg. + Azitromycin 250 mg.+Lactobacillus 60 m.s. Alu/Alu
2 TAB. ALSERA - N* 10X10 60.00
Serratiopeptidase 10 mg. + Nimesulide 100 mg.
3 TAB. AZAX KIT 1 Combikit 118.00
1 Fluconazole 150 mg. + 1 Azithromycin 1gm. & 2 Secnidazole 1gm. Combikit
4 TAB. COLDTER 10X10 38.00
Paracetamol 325 mg. + Phenylephrine 10 mg. + Levocetirizine 2.5 mg. + Caffeine 30 mg.
5 TAB. COLDTER PLUS 10X10 49.00
Nimesulide 100mg +Paracetamol 325 mg.+Cetrizine 5 mg +Phenylephrine 5mg +Caffeine 30 mg
6 CAP. MOXYTAR - D 10X10 68.00 78.00
Amoxycillin 250 mg. + Dicloxacillin 250 mg.
7 AXIFLO - OZ 30ml. 32.50
Ofloxacin 50 mg. + Ornidazole 125 mg./5 ml.
8 AXIFLO - OZ 60ml. 56.00
Ofloxacin 50 mg. + Ornidazole 125 mg./5 ml.
9 COLDTER 60ml. 46.00
Phenylephrine HCl 5 mg. + CPM 2mg. + Dextromethorphan HBr 10 mg. + Paracetamol 125mg / 5 ml.
10 COLDTER-PLUS 60ml. 48.00
Phenylephrine HCl 5 mg. + CPM 2mg. + Dextromethorphan HBr 10 mg. + Paracetamol 250mg / 5 ml.
11 TORCOX 100ml. 68.00 78.00
Phenylephrine HCl 2.5 mg. + Dextromethorphan HBr 10 mg. + Cetirizine 2 mg. + Menthol 1 mg./5 ml.
12 Drop. WAXTER 10ml. 44.00
Beclomethasone 0.025%+ Chloramphenicol 5.0% + Clotrimazole 1.0%+ Lignocaine2.00% Ear Drops
altar
Pharmaceuticals Pvt. Ltd.
TERMS & CONDITIONS

1.Changes in prices/wll discount: Altar Pharmaceuticals reserve all


right to change MRP,Trade price, discount, net etc (without any prior notice)

2. Supply : Supplies will be made within 3 working days of placing of order subject
to availabilit of goods. Orders should be placed in written by courier/post/fax. Goods
will be supplied in minimum quantities as specified in price-list. Road permit/waybill
should be send along with order.

3.Payment : Payment should be given in advance or against delivery only.


Goods send through bank will be through bank approved transporters only

4. Area : Franchisee should work in allotted area only. Company may Cancel
franchise forfit deposit in case of any infiltration outside allotted area.

5.Taxation : G.S.T. EXTRA


6. Business Volume : Minimum business Rs 30000/- (Thirty Thousand
Rupees ) per district per month.
7. Breakage/ Expiry : Breakage will be replaced only on presentation of valid
transporter's certificate.
8. Promotional Material : Promotional Material and gifts will be at actual
cost subject to availability.
9. For : Discount will be allowed 3 % of bill value against FOR Destination. ( if order
value is avove 25000/-)

10. Special offers/ free goods : Company will provide special offer/
volume discounts or free goods from time to time subject to sole discretion of
company.
11.Right to modify terms: Company reserves right to modify/ change
terms and condition to franchisee.

12. Noc/ Loc Expense: Noc/Loc expenses should be borne totally by


franchisee and Altar Pharmaceuticals will not share any expenses for local Noc or
donation to association.

13. Jurisdiction : Subject to Panchkula Jurisdiction only.


altar
Pharmaceuticals Pvt. Ltd.
Feedback/Information Form

Firm Details:
Name of Firm:
Address of Firm:

Pin Code: State :


Contact Details
Phone: STD Code 1. 2.
Mobil:
Suitable time to call :
fax: E-mail:
Firms Details (Necessary):
TIN/GST NO:
Local ST No:
Drug Lic No: 20 B 21B
Banker Name and Address:

Area of operation ( Mention each districts) :

Contact Person :
Firm Details:
Transporter :
Nearest Railway Station :

Name, Qualification and Date of Birth - Proprietior / Partner / Directors :

Business Details (optional):


Approx tunover for last 3 year (if applicable):

Other distributorship/ Franshisee held ( if applicable):


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