Online application for C&F agency of Raymond Pharmaceutical Pvt. Ltd.

Candidate’s name

Firm/Company name (If any)

Firm/Company address (If any)

Phone number

Email address

Territory you wish to operate

Constructed room details of adequate space in compliance of Drugs & Cosmetics Act, 1940 for Wholesale Drug Licenses, to store goods in godown for supplying in the respective district:

Details of premises available for C&F operation

Computer with printer Yes No

Air Conditioner Yes No

Refrigerator Yes No

Ownership agreement / Rental agreement of the godown available? Yes No

Academic background:

Qualification

College / Institution studied

Address of college / Institution

Work experience, if any

Names and contact details of two respectable persons who can be contacted as your referees:

Name of referee 1

Contact number

Address

Name of referee 2

Contact number

Address