Company Name: [text* Company-Name]
Contact Person: [text* Contact-Person]
Mobile: [text* Mobile]
Product name: [text* Product-name]
Product dosage form: [text* Product-form]
No of units per container: [text* number]
Container description: [text* Container]
Other notes: [text* notes]
Attach COC
Attach license
Please note this process may takes 48 working hours.
