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ANNEXURE –I

Request form for Corrective Action and Preventive Action (CAPA)

Production
Originating Department
Date
Name

CAPA/PR/01/21
Request No.

Present Process / Problem : Mix-up in single carton of Merc Sol 3X is found in Titanium 3X Tablet
during Packaging.

Head of Originating Department :

Signature/Date

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