REG. RENEWAL.LAST DATE WITHOUT FINE EXTENDED TO 31.3.2012 . FILLUP THE RENEWAL FORM AND SUBMIT . OR. SMS.. IN THE FORMAT [NAME SPACE REG. NO. SPACE PROFESSIONAL ADDRESS] TO 9495580951 . .
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APPLICATION FOR RENEWAL OF PHARMACY REGISTRATION CERTIFICATE FOR THE YEAR -2012
Name
*
Reg. No.
*
Name and Address of Business Place / Establishment
District
Alappuzha
Ernakulam
Idukki
Kollam
Kannur
Kasaragod
Kottayam
Kozhikode
Malappuram
Palakkad
Pathanamthitta
Thrissur
Thiruvananthapuram
Wayanad
Residential Address
*
Disctrict
Alappuzha
Ernakulam
Idukki
Kollam
Kannur
Kasaragod
Kottayam
Kozhikode
Malappuram
Palakkad
Pathanamthitta
Thrissur
Thiruvananthapuram
Wayanad
Cell Phone Number
*
E-mail ID
*
Land Phone number