Reprocess - pharmabeginers



Section A: Initiation Mock Recall No.:Initiation Date:Market (Sale/Export/PS):Country: Product Details:Brand NameGeneric NameMfg. Lic. No.Batch No.Batch SizeDispatch Qty.Pack SizeMfg. DateExp. Date Initiated By (QA)NameSignDate Section B: Review & Approval of Recall Review & Approval by Plant HeadComments: Mock Recall: Approved Not ApprovedNameSignatureDateReview & Approval by Head-QAComments:Mock Recall: Approved Not ApprovedNameSignatureDateSection C: Contact details of Mock Recall co-ordination committeeSr. No.DesignationNameTelephone No.Fax No.Mobile No.Head QA (Site)Head ProductionHead WarehouseHead Plant Head DistributionAny Other:Details updated By (QA)NameSignDateSection D: Mock Recall Communication:Mock Recall communication to be sent to all the stakeholders to whom the product is distributed. If required attach annexure for more municated toContact munication Means (Phone, Fax, E- mail, other means)Communicated By (Sign/ Date):Section E: Mock Recall Intimation:Mock Recall No.: Date: Part A:Brand NameGeneric NameBatch No.Batch SizePack SizeMfg. DateExp. DateQuantity Released for Distribution: ______________________________________Received Quantity from Production: _____________________________________Location Dispatch Qty.Reference Invoice/ bill No.Invoice DateTOTALNot ApplicablePart B (To be filled by the branch / depots/ distribution location)Name of Branch/Depots/Distribution Location__________________________________.STOCK DETAILSProduct NameBatch No.Pack Quantity received Quantity distributed Stock Quantity Please attach the distribution record with signature & stamp Details given by: Name: Signature :Section F: Reconciliation:Mock Recall No.: Date: Brand NameGeneric NameDateName of BranchQuantityVarianceRemarkDispatchedReceivedBatch No.TotalReconciled By- WH (Sign/ Date):Sign/Date (Verified by – QA):Verified By (Sign/Date): Head-QA/ DesigneeSection F: Evaluation and Closure of Mock Recall:Sr. No.CheckpointYes No1.Did all the recipients receive notification of this recall & understood the latter and followed the instructions? 2.Recall has reached upto the level (If No, give details):__________________________________________________________________________________________________________________________3.Did whole distributed batch reconciled successfully?Summary Report of Recall/ withdrawal:Mock Recall: SatisfactoryNot SatisfactoryClosure Approved By Head-QA/ DesigneeNameSignatureDateNote: Mock Recall process shall be completed within 30 working days from the date of initiation. ................
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