LEON PHARMACEUTICALS LIMITED

Satkhamair, Sreepur, Gazipur.

Department Quality Assurance
Title In-Process Analysis Request & Report Sheet
SYRUP MO No.:

From: Production Department To: QA Department

Product Name : Leozinc -B Syrup Batch No.:

Product Code : LZSY02 Batch Size:
Product Strength : Elemental Zinc 10 mg , Thiamine HCL BP 5mg , QC Ref No.:
Riboflavin BP 2 mg , Pyridoxine HCL BP 2 mg & Nicotinamide BP 20 mg / 5ml
.:
Sl. Quality Control Department
No. Production Department

01. ANALYSIS REQUEST SPECIFICATIONS ANALYSIS REPORT

Interim report after mixing thoroughly:
1. Appearance 1. A yellow syrupy liquid having sweet taste and slight 1.
metallic taste free from any visible foreign particles.
2. Identification
3. Odour 2. Must comply with the identification test. 2.
4. Taste 3. A blended flavour of strawberry. 3.
5. pH 4. Palatable with slight metallic taste. 4.
6. Weight per ml 5. 3.5 to 4.5. 5.
7. Assay: (Active Ingredient/5ml) 6. 1.100 g/ml to 1.30 g /ml. 6.
7. 95% to 110% of the stated amount of Elemental Zinc , 7.
Thiamine HCL , Riboflavin BP , Pyridoxine HCL &
Nicotinamide BP.

Remarks:
Signature & Date:____________ Signature (QC) & Date:_____________

02. Interim report at the beginning of Filling:

1. Filled Volume 1. 100.00 ml to 101.50 ml.

1.

2. Cap Leakage Test 2. Must be leak proof.

2.
Remarks:
Signature &Date:_____________ Signature (QA) & Date:_____________

03. Final report after Packing:

1. Batch No. 1. . 1.
2. Mfg. Date & Exp. Date 2. Mfg. Date: & Exp. Date: 2.
3. Price 3. 3.
Signature &Date:_____________ Remarks:
Signature (QA) & Date:_____________

Checked By: ____________________ Date: ______________________

Form No.: QA/FORM/IPC/ LZSY02 Version: 01 Effective Date: 01.06.2014

 LEON PHARMACEUTICALS LIMITED
Satkhamair, Sreepur, Gazipur.
Department Quality Assurance
Title In-Process Analysis Request & Report Sheet

Checked By: ____________________ Date: ______________________

Form No.: QA/FORM/IPC/ LZSY02 Version: 01 Effective Date: 01.06.2014