Company Name
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Quality
Assurance Department
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Form No.
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Revision No.:-
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Issue Date:-
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Product:
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Batch
No.:
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Pack
Size
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Mfg.
Date:
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Exp.
Date:
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QA
No:
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B.
Size:
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Quantity:
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Date:
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Observations
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Compliance to Requirement
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Yes
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No
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Sign
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Master
Shippers Checked For
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Verification Description
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Claim Quantity
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Correct
Labeling
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Correct
Packing
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Outer
Shippers Checked For
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Claim Quantity
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Correct
Labeling
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Correct
Packing
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Outer
/ Unit Cartons Checked for
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Product Name
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Batch No.
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Manufacturing
Date
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Expiry Date
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M.R.P Rs.
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Pack Size
Quantity
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Blisters / Vials / Ampoule/
Bottles Checked for
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Correct printing / Correct labeling
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Product Name
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Batch No.
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Manufacturing
Date
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Expiry Date
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M.R.P. Rs.
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Documents
Review
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||||||
In-Process
Documents Verification
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Final Release
Documents Verification
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Reconciliation
and other verification
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Release for Sale
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Hold
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Remarks:
________________________________________________________________________________
Q.A. Officer _____________________ Q.A. Manager _________________
Signature /
Date
Signature / Date
Prepared By:
QA Officer
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Reviewed By:
QA Manager
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Authorized By:
Director
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