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Application Form for Pharmaceutical Product
Arabic
home
about us
shop
Our Brands
Nuriderma
Toniderma
Avius
contact us
I have a project
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Application Form for Pharmaceutical Product
Arabic
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I have a project
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Project
*
Cosmetic
Food
Account Manager
Account Manager
Company Name(English)
*
Company Name (Arabic)
*
Trade Name (English)
*
Trade Name (Arabic)
*
Product Name
*
Contact Information
Name
*
Mobile Num
*
Email
*
Primary packaging
Primary packaging
*
Jar
Bottle
Tube
Sachets
Jar
*
Plastic
Glass
Bottle
*
Plastic
Glass
Tube
*
Plastic
Laminated
Description:
*
Primary packaging
*
Jar
Bottle
Blister
Powder Sachets (Polyethylene Bag)
Jar
*
Plastic
Glass
Bottle
*
Plastic
Glass
Blister
*
Colors
Transparent
Other:
*
Primary Packaging Accessories
Primary Packaging Accessories
*
Cap
Pump
Sprayer
Other:
Cap
*
Flip Top Cap
Screw Cap
Desktop Cap
Pump
*
White
Black
Other
Description:
*
Primary Packaging Accessories
*
Cap
Other:
Cap
*
Flip Top Cap
Screw Cap
Single Use Tube
*
Color:
Primary packaging Color
*
Primary Packaging Accessories Color
*
Secondary packaging:
Secondary packaging:
*
Box
With Out Box
Primary Packaging Options :
*
Direct Printing
Label Sticker
Label Sticker Options
*
White
Transparent
Mataliz
Label Sticker Options
*
Colored
Transparent
Mataliz
Shrink
Secondary packaging specification:
*
Cellophane matt
Cellophane Glossy
Stamp
UV
Coverage
Other:
Information
Astrix Pharma manufacture Information To be added?( in case If the product is European)
*
Yes
No
Ingredients:
*
English only
Arabic only
Arabic & English
Barcode
*
From Astrix Pharma
From Client
Barcode
*
SFDA Registration
*
Astrix Account
Client Account
Username
*
Password
*
Primary packaging Picture:
*
Click or drag files to this area to upload.
You can upload up to 4 files.
Age Group
*
Infants
Adult
Children
Women
Men
Master Formula Details:
Master Formula Details:
*
New Formula
Old Formula
External Supplier
Master Formula Details:
*
New Formula
Old Formula
Active Materials Details:
*
Product color and odor:
*
Dose Added by:
*
Client
R&D
Dose Name
*
Flavors :
*
Specific Flavor:
Non-Flavored
Flavor:
*
Specific Claims
*
The Primary Packaging Shape Approved by Sale
Yes
No
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