Navsari Additional Free Scheme Request.
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ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15 Name of the PSR: Name of the AM: Head Quarters: Name of the RM: State: Name of the SM: Name of the Doctor Name of the Chemist Name of the Stockist Any SAS service done during this year? Yes (or) No SAS Amount Rs. Dr is having attached Chemist? Yes (or) No Qty. (Per Month) Primary Offer Available Additiona l Offer requested
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Free scheme request
Transcript of Navsari Additional Free Scheme Request.
HQ1ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:Name of the AM:Head Quarters:Name of the RM:State:Name of the SM:YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny SAS service done during this year? Yes (or) NoSAS Amount Rs.Dr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (Per Month)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GM
HQ2ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:Name of the AM:Hq:Name of the RM:State:Name of the SM:YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny CRM service done during this year? Yes (or) NoCRM AmtDr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (PER MONTH)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GMNOTE: THIS IS ADDITION TO OUR PRIMARY FREE OFFER (LIST ATTACHED)
HQ3ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:Name of the AM:Hq:Name of the RM:State:Name of the SM:YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny CRM service done during this year? Yes (or) NoCRM AmtDr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (PER MONTH)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GMNOTE: THIS IS ADDITION TO OUR PRIMARY FREE OFFER (LIST ATTACHED)
HQ4ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:Name of the AM:Hq:Name of the RM:State:Name of the SM:YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny CRM service done during this year? Yes (or) NoCRM AmtDr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (PER MONTH)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GMNOTE: THIS IS ADDITION TO OUR PRIMARY FREE OFFER (LIST ATTACHED)
HQ5ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:Name of the AM:Hq:Name of the RM:State:Name of the SM:YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny CRM service done during this year? Yes (or) NoCRM AmtDr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (PER MONTH)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GMNOTE: THIS IS ADDITION TO OUR PRIMARY FREE OFFER (LIST ATTACHED)
HQ6ADDITIONAL OFFER CLAIM FORM FOR THE YEAR 2014-15Name of the PSR:SANJEET KUMARName of the AM:BIJESH KUMAR JATHq:NAVSARIName of the RM:State:GUJARATName of the SM:SUBHASH CHANDAR JHAYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYName of the DoctorAny CRM service done during this year? Yes (or) NoCRM AmtDr is having attached Chemist? Yes (or) NoName of the ChemistName of the StockistProductQty. (PER MONTH)Primary Offer AvailableAdditional Offer requestedSupply from C&A or StockistActon OR TabsArk AP TabsArk 75 TabsArk GelAscazin SyrubCartivit TabsCofstop A SyrupCofstop Z SyrupEpinormFolinz TabsIben Plus TabsLancid TabsLasma 10 TabsLasma 4 TabsLasma 5 TabsLasma LC Kid TabsLasma LC TabsP-125 DropsP-125 SusP-125 TabsP-250 SusP-250 TabsP-500 SusP-500 TabsP-650 TabsP-750 TabsPexoclav 375 TabsPexoclav 625 TabsPexoclav Dry SyrupPexoclav DT TabsPexoflox 100 TabsPexoflox 200 TabsPexomox 250 TabsPexomox 500 TabsPexomox Kid TabsSofinox 10 GMSofinox 5 GMSoyamin 22 LiqSpectratil 100 Dry SyrupSpectratil 100 TabsSpectratil 200 TabsSpectratil 50 Dry SyrSpectratil 50 DT TabsSpectraxime 125 TabsSpectraxime 1.5 GM InjSpectraxime 250 InjSpectraxime 250 TabsSpectraxime 500 TabsSpectraxime 750 InjSpectrazid 1 GM InjSpectrazid 250 InjThermal S SusThermal S TabsTrifer DropsTrifer SyrupTrifer TabsXfer-XT TabsZelita 7 TabsZincofer LiqZincofer Nurture TabsZincofer TabsZincovit DropsZincovit SyrupZincovit TabsZincofer XT TabsArk Spray 100 GMArk 75 SR TabsArk 100 SR TabsArk 50 SR TabsArk Spray 35 GMArk Spray 55 GMhimansu ladnoyesratangurukurpa/gayatri50001010%stockist10Y10Yjignesh gadiyalinoyesmistrygurukurpa/gayatri1000020%stockist20y20y20y20yajit soninoyeseye rotrigurukurpa/gayatri1000020%stockist20y20y20yparmiyal ladnoyesomgurukurpa/gayatri1000020%stockist20y20y20yNOTE: THIS IS ADDITION TO OUR PRIMARY FREE OFFER (LIST ATTACHED)
