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Date of Publication
Version 2.0 06 June 2018
Comment Form
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Product Name :
Article Number :
Product Batch Number :
Batch Record Number :
Page: X of n
Explanation: √= oK; ο= missing, not correct; n.a. = not applicable
Incoming
sender: Due date:
date:
Content:
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- Compounding
Ingredients, intermediates and packaging material
with article number and batch number
Quality Control records/ analytical batch records
available
→ attachments correct
- Labels:
→ content correct
→ balancing correct
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Delivery receipt
- drum- number/-name or amount of product
- signatures complete
- Product Quality Review:
Data transferred
Product .………........................................................................................................
Batch.no ...........................................................
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Comments:
...............................................................................................................................................
..................................................
...............................................................................................................................................
..................................................
...............................................................................................................................................
.................
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Product:
Description
Investigational
medicinal
product:
* EudraCT * Study protocol
number: code, and Centre
Batch: In charge:
Date of
Expiry date:
manufacture:
Planned o placing o clinical trial o stored until processing
release: o release regular o release quarantined
* If known
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Comments:
Result:
o complies with all the above points, batch can be released
Measures:
o no release and destruction
o quarantine and the following measures:
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Batch Number
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1.1.1 Example 1
Batch size:
Batch number: Date of production:
Expiry date:
Aluminum foil
Leaflets
Intermediate
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Certificate of analysis
In Bulk
yes no
Approval of proposed changes yes
no
Notes:
Date:
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