Utilization Certificate Form: Required for Issuance of Restricted Medicine from CGHS

HomeCghs

Utilization Certificate Form: Required for Issuance of Restricted Medicine from CGHS

Utilization Certificate Form: Required for Issuance of Restricted Medicine from CGHS

Utilization Certificate

This is to certify that … … … … … … … … … … … … … … (Name of Medicines, quantity, dose, frequency) … … … … … … … … … … … … …  issued to … … … … … … … … … … … … … … (Name & Token No of Patient /Name of Dispensary) issued on… … … … … … … … … (Date of issue) has been utilized /will be utilized by(Date) … … … … … … … If required empty strips/vials will be submitted.

Signature of Patient
Token No:
Address & Telephone No
Signature of the Specialist/ CMO
Date:-
Stamp

Counter Signature of CMO I/C WC with Stamp

View: CGHS: Instructions for Issuance of Restricted Medicines

utilization-certificate-form

Click here to view/download the PDF

[https://cghs.gov.in/showfile.php?lid=6216]

COMMENTS

WORDPRESS: 2
  • Dg Club 5 months ago

    Thank you for shedding light on the Utilization Certificate Form and its importance for obtaining restricted medicine from CGHS. This information is extremely helpful for those of us navigating the process. The step-by-step guidance provided in your post will definitely make it easier to understand the requirements. Looking forward to more updates on related topics!

  • Satyapal Singh 3 years ago

    utilization certificate nahi mil rha hai.