VENDOR SAMPLES REQUEST CUM REPORT

REQUEST

 From :

 Quality Assurance Department

 To :

 Quality Control Department

Name of Raw Material (RM) / Packaging Material (PM)
Batch No.s / Mfg. date
Vendor Name
Manufacturer Name
Requirement	Complete Analysis /

Head – Quality Assurance	Name	Signature	Date

REPORT

 From :

 Quality Control Department

Remarks	Material complies / does not complies the specification.
Enclosures	Analytical Data
	Certificate of Analysis (COA)

Head – Quality Control	Name	Signature	Date

 

 

PROCESS DEVELOPMENT  LAB / R&D

Remark from PD / R&D	Material complies / does not complies the specification.
Enclosures	Input details
	Batch Processing Details
	IPQC results
	Stage wise – Yield data
	API Test report & COA

 Reviewed by

Head – Quality Control	Name	Signature	Date
Head – Manufacturing / Scientist – R&D	Name	Signature	Date

QA Evaluation :

Material Name          ______________________________________________________________________

     Vendor Name            _______________________________________________________________________

   Manufacturer Name _______________________________________________________________________

 Report:  The above material vendor and manufacturer is Approved / Rejected

Head – Quality Assurance	Name	Signature	Date