1964_PHARMACY_AND_POISONS_REGULATIONS — Page 78

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A 78

[Subsidiary]

L.N. 85/87

CAP. 138] Pharmacy and Poisons Regulations

4. 樓宇電話號碼

[1987 Ed.

5. 根據藥劑及毒藥條例第十一條第(1)款規定親身在場，或負責監督毒藥零售業務的註冊藥劑師姓名.

現呈交上文第五段所提藥劑師的註冊證明書複本一份，以支持本申請書。

簽署..

簽署人全名......

代表此商號簽署.

(商號名稱)

FORM 16

PHARMACY AND POISONS ORDINANCE

(Chapter 138)

CERTIFICATE FOR REGISTRATION OF PREMISES UNDER SECTION 13

This is to certify that the premises known as

[reg. 24C.]

(Name of business)

(Address of premises)

period from the date of this certificate until

and situated at

are, for the

(Date of expiry)

registered under section 13 of the Pharmacy and Poisons Ordinance as being premises where the retail sale of poisons may be conducted, subject to the conditions endorsed hereon.

Dated this

day of

19....

.......

for Pharmacy and Poisons Board.

CONDITIONS

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A 78 [Subsidiary] L.N. 85/87 CAP. 138] Pharmacy and Poisons Regulations 4. 樓宇電話號碼 [1987 Ed. 5. 根據藥劑及毒藥條例第十一條第(1)款規定親身在場，或負責監督毒藥零售業務的註冊藥劑師姓名. 現呈交上文第五段所提藥劑師的註冊證明書複本一份，以支持本申請書。簽署.. 簽署人全名...... 代表此商號簽署. (商號名稱) FORM 16 PHARMACY AND POISONS ORDINANCE (Chapter 138) CERTIFICATE FOR REGISTRATION OF PREMISES UNDER SECTION 13 This is to certify that the premises known as [reg. 24C.] (Name of business) (Address of premises) period from the date of this certificate until and situated at are, for the (Date of expiry) registered under section 13 of the Pharmacy and Poisons Ordinance as being premises where the retail sale of poisons may be conducted, subject to the conditions endorsed hereon. Dated this day of 19.... ....... for Pharmacy and Poisons Board. CONDITIONS

Baseline (Original)

A 78 [Subsidiary] L.N. 85/87. CAP. 138] Pharmacy and Poisons Regulations 4. 樓宇電話號碼 [1987 Ed. 5. 根據藥劑及毒藥條例第十一條第(1)款規定親身在場,或負責監督毒藥零售業務的註冊藥劑師姓名. 現呈交上文第五段所提藥劑師的註冊證明書複本一份,以支持本申請書。簽署.. E........ 簽署人全名...... 代表此商號簽署. (商號名稱) FORM 16 PHARMACY AND POISONS ORDINANCE (Chapter 138) CERTIFICATE FOR REGISTRATION OF PREMISES UNDER SECTION 13 This is to certify that the premises known as [reg. 24C.] (Name of business) (Address of premises) period from the date of this certificate until and situated at are, for the (Date of expiry) registered under section 13 of the Pharmacy and Poisons Ordinance as being premises where the retail sale of poisons may be conducted, subject to the conditions endorsed hereon. Dated this day of 19.... ....... for Pharmacy and Poisons Board. CONDITIONS

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