Product Quality Report (PQR) Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.TitleProfDrMrMrsSirMissName *Phone Number *Email *Are you a healthcare professional? *YESNOCan we follow up with you if we have additional questions related to your report? *YESNODue to the nature of Pharmacovigilance (PV) activities and legal obligations to follow up, Wega Healthcare might formally contact you, in an effort to obtain additional details to facilitate a thorough case evaluation.Product *Bonecare PlusBonecare Plus SuspensionCollacare ForteItorplusMontezine PlusNervidocZof-MRProduct Batch Number:Product Expiry Date *Product Storage History (In summary)Describe in details the Product Quality Complaint *Attach a File: (Please upload a file up to 5MB) Drag and drop files here or Browse Files Upload upto 5 Files. Max File Size: 5 MB I confirm that the details I have provided are correct. *ConfirmBy clicking the "Submit" button, you confirm your consent to the processing of the personal data as provided in the request form. Wega Healthcare Ltd and its affiliates solely to provide a response to your request will use personal data.Submit
