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    This document is a funding request form for a doctor's conference sponsorship. It provides details about the doctor such as their name, medical registration number, area of practice, and contact information. It specifies that the requested sponsorship is for travel expenses to attend a conference alone, without a spouse. The conference details and expected budget impact are noted. The doctor's sales performance history and potential with various pharmaceutical brands are outlined. Recommendations from regional and sales heads support funding the doctor as a good investment. The total requested sponsorship amount is Rs. 40,000.

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    This document is a funding request form for a doctor's conference sponsorship. It provides details about the doctor such as their name, medical registration number, area of practice, and contact information. It specifies that the requested sponsorship is for travel expenses to attend a conference alone, without a spouse. The conference details and expected budget impact are noted. The doctor's sales performance history and potential with various pharmaceutical brands are outlined. Recommendations from regional and sales heads support funding the doctor as a good investment. The total requested sponsorship amount is Rs. 40,000.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
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    129 views6 pages

    XVXV

    Uploaded by

    gajbe_sid8992
    This document is a funding request form for a doctor's conference sponsorship. It provides details about the doctor such as their name, medical registration number, area of practice, and contact information. It specifies that the requested sponsorship is for travel expenses to attend a conference alone, without a spouse. The conference details and expected budget impact are noted. The doctor's sales performance history and potential with various pharmaceutical brands are outlined. Recommendations from regional and sales heads support funding the doctor as a good investment. The total requested sponsorship amount is Rs. 40,000.

    Copyright:

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    of 6

    CALM/Scope/SP Camp

    Date 14/06/2009

    B.O. kishor

    Doctor's Name DR. V S AGARWAL

    MCR.No 58

    Nature of Practice MD(MED)

    Doctor's Mobile No. 9823042700

    Nature of Expenditure:
    1. Sponsorship to Conference

    Travel no Stay

    Alone no With Spouse

    Registration no No. of Heads

    Details of Conference
    2. Any other (Specify) P2D Acedemic Help provided as reimbursement of receipts

    In case DD, to be paid in


    favour of DR ONLY

    Balance Budget (after this exp.) As per R O


    Visit Details for Last three months:
    mar apr
    B.O 4 , 23 17 , 22
    ABM 0
    RBM
    Business Details/Month I joine in mar
    Name. central med

    Brand Current Support Units Potential Units


    OLMY A 1BX 10
    ATORVA TG 1BX 10
    NUR 75 1BX 10
    Euglim M1 MG 5 10
    Euglim M2 MG 4 10
    Euglim MP2 MG 1BX 10
    Euglim MP1 MG 1BX 10
    euglim 1mg 5bx 10
    Total Value Rs 10000 50000
    Any activity done till date
    Activity Expense
    olmy at home 1000

    Regional Head recommendation :- Sanjay M Satav

    DR is very potential and will reciprocate to demands, good investment opportunity.

    Sales/Marketing Head Recommendation

    Unit= Box/Vial/Inj./Infusion
    Kindly fill all the columns to process your request
    CALM/Scope/SP Campign Investment Format

    H.Q. nagpur Region Pune

    Qual/Sp. M.D. ( Med. ) Place nahpur

    Nur.Home no Hosp. Attachment

    Resi No. 9823042700

    Clinic No. na

    no Conveyance no

    no Family no

    no

    ed as reimbursement of receipts of the same.

    Rs.40000 As per H O Rs.40000

    may Reasons If Visits are < 2 / Month/BO


    7, 23 DR GIV CALLS ONCE IN MONTH

    Expected Increase
    Current Support Units Potential Units Units By What Date
    4bx july
    3bx august
    4bx september
    10bx october
    7bx november
    4bx december
    10BX january
    15bx february
    26000
    ABM's recommendation:
    Name: vaccent Hq. nagpur Sign:

    Give details of DD/Cheq. to be drawn in favor of & payable

    dr only
    Divisional Head Approval
    y

    Expenses

    5000
    Total Exp

    5000

    h/BO

    Remarks
    o be drawn in favor of & payable at

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