Pharmacy Drug Submission Form

Drug Category: Analgesics/Antipyretics Antibiotics Antifungals Insulin Vaccines Description (Generic Name): Paracetamol Aspirin Ibuprofen Amoxicillin Insulin Strength: Formulation: Injections Liquid Tablets Capsules Subformulation: Subcutaneous Intramuscular Intravenous Brandname: Country of Origin: Local Supplier: Unit of Issue: Tablet Bottle Price per Unit: Availability: Enough Some Limited Stockout papID: Date Submitted: Time Updated: Updated By: