From :M/s Apna Medical Store KKR Road Dhand Distt.

Kaithal To:Senior Drugs Control Officer, Cum Licensing Authority, Ambala Zone, Ambala Sub:- Change of Registered Pharmacist of R.S.D.L of M/s Apna Medical Store Dhand Distt. Kaithal.

Res./Sir, With due respect that I am applying for the change of Registered Pharmacist of my firm M/s Apna Medical Store Dhand Distt. Kaithal having R.S.D.L No. 1633-OBR & 1633-BR valid upto 17/11/2018. The previously Registered Pharmacist Mrs. Sangeeta Rani w/o Ram Parshad was Resigned on dated 24/11/2013 and now I appointed New Pharmacist Sunil Kumar s/o Sh. Kalka Parshad R/o Dhand Distt. Kaithal on dated 25/11/2013. That no any retail sale was done by me during gap period of both Regd. Pharmacist. All necessary documents are attached with this application. Kindly enter the name of the New Regd. Pharmacist Sh. Sunil Kumar in my R.S.D.L as soon as possible. Thanking you . Yours obediently, Prop:M/s Apna Medical Store KKR Road Dhand Distt. Kaithal

FORM - 19 See Rule 59(2)

Application for Change of New Registered Pharmacist in Retail Sale Drug License to sell stock or exhibit for sale or distribution of drugs other than those specified in Schedule-X. 1. I, Rajinders Kumar/o Sh. Bhag Singh. Prop. Of M/s Apna Medical Store herby apply for the license to sell Retail sale Drugs specified in Schedule C and C(1) excluding those specified in schedule X and drugs other than those specified in Schedule C and C(1) and X to the Drugs and Cosmetics Act 1940 and Rule 1945 and also to operate a pharmacy in the premises situated at Kurukshetra Road Dhand Distt Kaithal. 2. the Sale and dispensing of Drugs will be made under the person at supervision of a qualified person. Name Sunil Kumar Qualified Registered Pharmacist Registration No. 24440 Dated 12/11/2013 3. Categories of drugs to be sold NONBIOLOGICAL. 4. Particulars for special storage accommodation kept Refrigerator in working condition.

Prop:25/11/2013 M/s Apna Medical Store KKR Road Dhand Distt. Kaithal