ANNEX 3.

LOGO PT PT. xxxxxx

SUMMARY OF STABILITY STUDY REPORT

Lab Organization : Package : Status :

Document No : Batch Number : Position :
Item Number : Batch Size : Storage Condition :
Product Description : Manufacturing Date :
API Source : Manufacturing Site :
Description/Param T-0 MS/ T-3 MS/ T-6 MS/ T-9 MS/ T-12 MS/ T-18 MS/ T-24 MS/ T-36 MS/
No. Specification
eter dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS dd/mm/yy NMS

Prepared by : Reviewed by : Approved by :

Designation TS Specialist TS Manager Quality Manager
Signature

Date
FIP-FR-C.SQM.0126a rev 0.0 eff date 27/04/2015