Online System for Medical Devices
Form MD-30
[see sub-rule(1) of rule 67]
Memorandum to the Central Medical Device Testing Laboratory
Personal Information and Medical Device Details
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* All fields are mandatory
Testing Laboratory:
*
Select
Central Drug Testing Laboratory, Chennai
Regional Drugs Testing Laboratory, Chandigarh
Regional Drugs Testing Laboratory, Guwahati
Central Drug Testing Laboratory , Hyderabad
Central Drugs Laboratory, Kolkata
Central Drugs Testing Laboratory, Mumbai Central
Generic Name of Device
*
Brand Name(Optional)
Medical Device Grouping Category:
*
Select
IVD-Kit
IVD Group
IVD Cluster
Group-MD
Single
System
Family
Notified Category of Medical Device:
*
Select
Class of Device:
*
Select
Class A
Class B
Class C
Class D
Sterlization:
*
Select
Sterilized
Non-Sterilized
Both
Shelf Life :
*
(In case of Non-Sterilized products,kindly write NIL for shelflife)
Storage Condition:
*
Pack Size :
*
Product Description
*
Full Name
*
Mobile No:
*
Address
*
EmailId
*
Packet No
*
Serial No
*
Offence Alleged
*
Matter on which opinion is required:
*
Fees Paid:
*
Other Contact No
Batch Number
*
Sample Number(If any)
Quantity Sent
*
Quantity Unit
*
Select
number
Manufacturing date:
*
Expiry date:
*
Remarks
*
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