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PHIEU LAY MAU - GIAO Ten san pham Ngay san

NHAN MAU THAM xuat (Mf.
(Product Name):
NH QUI TRNH SAN Date) :
SHINPOONG XUAT Vin Nang Melotop
DAEWOO (SAMPLE DELIVER - RECEIVE
PHARMA
SHEET So lo: MEC- C lo :
FOR PRODUCTION PROCEDURE 7003
(Lot Size)
VALIDATION) (Lot No.)
Ch ky
Mau lay (Sample)
(Signature)
Ngay So Ng
Ng
lay l i
Stt Cong oan Yeu cau Ng i
mau ng ch
(No. (Processing kiem i nha
(Sampli (Qu Ma so ng
) Stage) nghiem lay n
ng anti (Code) kien
(required (Take (Rec
Date) ty) (Obs
test) n by) eive
erve
d by)
d by)
ng 01121017/MEC-
1. nang T1 10 v
7003
(Phu
12.10.17 cm 1- 02121017/MEC-
2. T2 10 v
Tc 7003
trung 03121017/MEC-
3. bnh)
T3 10 v
7003
01161017/MEC- Ham
4. ng T1 10 v lng
7003
nang Meloxica
16.10.1 (Phu 02161017/MEC-
5. cm 2- T2 10 v m
7 7003
Tc
trung 03161017/MEC-
6. bnh) T3 10 v
7003
Phu cm
18.10.1 01181017/MEC-
7. cui- Tc 10 v
7 thp 7003

QA-F0015(18.10.2012)/02