Issue No.

: 001
Technical procedure
Issue Date: 1/02/2022
ISO 17025:2017 Revision No.: 000
TP-7.04-01 Revision Date.: --
Copy No. ( ) Handling of test items Page

APPENDIX 1
Request for Sample Analysis
Date: / /
Sample Name: ....................................................................................................
Sample B.N#: ………………………………………….
Quantity: …………………………………………………
Man. Date: ……………………. Exp. Date: ………………………

Required Tests:
Date/Time of
SN Required Test Notes
Result

*Supplier certificate of analysis (raw materials)? Yes No

*Sample accepted? Yes No
*Anomalies and deviation of sample from specs (in case of sample rejection)
....................................................................................................................................
*Is there any other requirements? Yes No
....................................................................................................................................

Lab Manager:
Signature: ………………………….
F 7.04-01/01
Issue No.: 001
Technical procedure
Issue Date: 1/02/2022
ISO 17025:2017 Revision No.: 000
TP-7.04-01 Revision Date.: --
Copy No. ( ) Handling of test items Page

APPENDIX 2

Sample rejection/disposal form

Date: .................................

Sample(s) name: .................................................................................

Sample size: ......................................................................................

Sample B.N#: .......................................................................................

Reasons for rejection..........................................................................................

...........................................................................................................................

Date of Rejection: ................................... Date of Reception: .............................

Lab Manager

Name: ..........................................................

F 7.04-01/02 Signature:

..........................................................
 Issue No.: 001
Technical procedure
Issue Date: 1/02/2022
ISO 17025:2017 Revision No.: 000
TP-7.04-01 Revision Date.: --
Copy No. ( ) Handling of test items Page
Appendix 3
CHECK LIST OF RECEIVING RAW / PACKAGING MATERIALS

Excipients Active ingredients Packaging materials Finished

‫مواد خام غير فعالة‬ ‫مواد خام فعالة‬ ‫مواد تغليف‬ products
‫منتج تام‬

‫محضر فحص واستالم الخامات الموردة‬

Serial # :……………………….
Name of raw material:‫اسم الخامة‬: For product: ‫لمنتج‬:
Date of receiving: ‫ تاريخ االستالم‬Supplier: ‫الجهة الموردة‬:

Number of container: ‫عدد العبوات‬: Quantity in each container: ‫سعة العبوه‬:

Total quantity: number of container × quantity in each container =

= ‫& العبوات × سعة العبوه‬
‫ عدد‬:‫الكميه الكلية المستلمة‬

× =

Check list item Accepted Not accepted

‫مقبول‬ ‫غير مقبول‬

Outer container integrity ‫سالمة العبوة الخارجية‬

Cleaning of containers ‫نظافة العبوه الخارجية‬

Printing quality on the Label of supplier ‫وضوح البيانات علي تيكت المورد‬
‫‪Same data in the analysis certificate‬‬ ‫تطابق بيانات التكت وشهادة التحليل‬

‫المراجعة‪:‬‬ ‫أمين المخزن‪:‬‬

‫‪F 7.04-01/03‬‬