Phido F3yearyri~ mail: See oe [See Rule $9(2)) Application for grant or renewal of a licence to sell, stock, exhibit or offer for sale, or distribute drugs other than those specified in Schedule X perc LY eres oe ee ee At Ate TR. Domtiech.. ae Aialtt.... Medical... hereby epply for licence to sale by wholesale/retail drugs specified in Schedule ¢ and ¢(1) andexcluding those specified in Schedule x* and / rugs other than those specified in Schedule C,C(1) and x to the 8 and Cosnetics Rules, 1845* and alec to operate a pharmacy on the premises situated at ls sae Rie nur te MalG3. Kugrom . chi loor un Rood... Jao. Pals. Village .Begyici fall... Pans, . - (wa) rat Tape re 2. § The sale and dispensing of drugs will be made under the personal Supervision of the registered pharmacist / competent person namely: — name. FP: THULAS!. Komag ..ovaiieication.. B: Phanmatze... a n.pno LSE AES AL we + Categories of drugs to be oid under 20 and 21 / 208 and 218 4. #Particulars for special sterage accommodation 11g Fay ute. 2. Aircoller Gredited to the Government under the nead of account . ver is not applicable if drugs w nly Le pe eetph alet 93469421. Pail bjt Goetlcr [See Rule 59(2)} Application for grant or renewal of a licence to sell, stock, exhibit or offer for sale, or distribute drugs other than those specified in Schedule X 2 rie. IM ee So, bake. TR. eis. ws... Anit.. Medi Ql... hexeby apply for licence to sale by wholessle/ratai1 drugs specified in Schedule € and C{i) and excluding those Specified in Schedule x* and / or drugs other than those specified in Schedule C,¢(1) and X to the Drugs nd Cosmetics Rules, 1945* and also to operate a pharmacy on the premises situated at fs, Boel. metas 20 tM 163. .Kephon...chitleor..maly Peed. a Baggies fates...facchey th, Gactupatte cm) 1O or cot § The sale and dispensing of drugs vill be made under the personal supervision of the registered pharmacist / conpetent person nami name... PHLAS/ KUMAR ouaritication..B- Pl wpe ISCR ECM... ante B03 ROD ¥ v 3, Categories of drags to be sold under 20 and 21 / 208 and 218 4. Particulars tor special storage accomoaation 1.L6) hile Its. 2. Rrcoller §. A fee of rupees eee |= eredited to the Government under the head of account ., bate: 5 ca a /partneeABBRAM 256688 | 19600| oo rth 194 Mentor, | | Feybernd and Mays | | !a 6p +91 9949398093 Foxconn SYSTEMS Jp We make technology work for you... part og on ace a © |HY pio Lasker [11800 Powter | Tota Wéea low Ee ltindoed.Be -21 s919394093 foxconn sy! SYSTEMS, “na332/7, ioe nd ppm 517425, chien Dt AP- sNeworeny pesktops, Laptop & Printers Servi Toner Cartridge Retin, EE... F pate:02-4o44o4-| jo. O83 ame: JY le }eshe— eappa ——~GSTIN: S7CI.PS7067K1ZF Paibata, 22nd ward Gudipalli Road, Kuppam - 517 425. Date: ox} 0m) 2. Dear Sir, We acknowledge with thanks the receipt of your esteemed eae ee 1326 914212 and we are glad to quote our rate a: ey (vol Description Roe quilt Coole Jaodel!— Be peqeep OM SHANTHI ENTERPRISES: NI Sales Tax Extra at the applicable rate Validity : Dolivery :eaerxr She. svozaass GSTIN: 37CUPS7067K12zF Mob: 9483512245 OM SHANTHI ENTERPRISES sorrrerie Paibata, 22nd ward Gudipalli Road, Kuppam - 517 425 No. 115 Date. O21 00/21)... btn Tay fedeth aba & Nee Pda. Dear Sir, We acknowiedge with thanks the receipt of your esteemed Enquire No. e Description PY LG, Wotdge Npsel!- Doo) AEIO OM SHANTHI ENTERPRISES PAIBATTA, 22 warp GUDIPAL! FROAD KUPPAM, GST TIN: 3701; Oc7KIE Sales Tax Extra at the applicable rate Validity : : O- Delivery : For ON HI ENTERPRISESYBi RECLARATION OF BUILDING OWNER From: To, oy ae re The Assistant Director, Hhate Trenoppa District Licensing Authority, ala Pesllds.£¥i.2. -Titepater. Bag Rigas. (Po)... PAA MOOX, a Gudlafalle ¢r2) Andhra Pradesh. Boal fi uA Bfenelxn hereby, deciore td’ I am. the owner of the Bolling sttasad ae DNo. MME Bou fal gach AMIN BEAU Pollel...fe,) Gudupatle (0) ehttteor Cot) have let outa portion of my above Bulding to Mis. ANCA... Med féab] Represented _by its Proprietor / Partner / Managing Diector / Authorised Signatory..LJ0¥%n...Jefes be. --to run medical business. "ws parton hes bea aloes D.to di: 162Mlade ga, fUBLA Vi). rage fad8 CP) Gah. flrhr.. tnd... CPé Kean. Lak > wand ‘the portion which was let cut admeasures../5:.c29..Se.meters. 4 Tam herewith submitting attested copy of E.C / ther legal document as a proof of ‘ownership of the premises and also the plan of the premises of the said building let ‘ut to the said firm duly attested by me. ae a Merja Yours faithfully SIGNATURE OF THE BUILDING OWNER. (Attested by Gazetted Officer), Pedal “8 Dodo" APMCIFMRI9OB{? or.SUBASH RAJA, CIVIL ASSISTANT SURGEON MBU5,2.0%8 PRIMARY HEALTH CENTRE APNCIFMRI90817 N-Katnapalli, Kuppam(M) CIVIL ASSISTANT SURGEON PRIMARY HEALTH CENTRE Nxathapall, Kuppam{t)Borneo Government of Indi Unique Identification AU meat Cite) 8g) Evcimen No: O7OSIDOLY S995 toe os Esa Hh Fnccome: 31923 ‘Sy exc ‘omg / Your Aachaar No. = 3906 1555 2284 "eo: a) Real a2 Be cece, ae OQ0kD gz =- Ay. ‘AADHAAR ‘saneese | INFORMATION # opbecaraap ony beep do apaadina Sancta Sp mages ct ee Spamargeceege ation ‘Sort uve mene per eee cet ‘Soden oye ters $80 cnet 2 na Bo eos ON sya accion Oo wean pd tecaren aaj aloo tod rss ened ORE Satep. a ossaiisite sen sates. 1 uasaire shodt ant 00 Oaasoery or6 Ate Sous Bavere bansado ged vod Sora Bae gy as seater tones Dace sosbotoancnct a Dae! aatanm comb att aot er etee sate | wotheve Ostae maouw cn SO ait fm epsruaradions a eso apeot Fintet ceswarngi bait se es fe spas oxyanar nae DvooU ens 1 Asst pale etl cit ce th 908} 208 ‘Seeudonoraton upon tps Da aera (myosin saya ae 12 Tes crew ear ase eset wer one arcu) Uaroapenid mina pry = ee SSmgunig naan hae’ Of Gomee tp ove = ‘ora ry 9 ur for of ram SB soe: aaa [Seem (Sac ann nae sn ees eeIN-APT7 t95t6001940W eundDate | O4-Apr-2008 00:37. AM NEWIMPAGG ($V) op 18050304 AP-CTRY AP-CHTiapamwtains uceihipe 11912308001 JT SRO CHITTOOR (f.0) Ricterance SUBIN-APAPrBoavanasss72a86 102028 Propeny averiaion Coneideratir Price (Re) Fist erty MW AAZENDRA ‘Secene Panty ‘Not Applicable Paid By (For When) ) AM AAZENDRA Stamp Duly Amount 100 ‘Stamp Duty Amounts.) Wesliadetian \ LISHAR GUPTA inp STAN VENDOR Nor sts007 of 208 cour, Be POUND, ay ELL 19977744230 RENT REND AGREDI: s Rent Agreement executed on this the 4 ape Pea on this the 4th day of MsRAJENDRA Son of Muneppa, residing at Nalagampalli Village Beggilapalli Penchayat,Gudupalle Mandal, Chittoor Dist AP hereinafter called es LESSOR/OWNER, AND J.V.TEJESH son of late J.R.Verkatesh, residing at D,No,1-17 Gundlanayanapal li Village & Post, Kuppam Mandal, Chittoor District, AP hereinafter Called as B TENANT, WHEREAS, the LESSOR 1s the OWNER OF the Schedule Mentioned shop room morefully described hereunder. The Owner agreed to letout the schedule mentioned shop room to the Tenant for a ie of 05 (Five) Years sates from to-day ee out ar 5 * 0004233772 “ADVOEA sist le aoa, Ci eraES. 00 b IN-APT71 T9845 137083 issued Date (8 Apr. 2024 09:38 AM NEWIMPACC (SVy ap 18090404/ AF-CTRY AP-CHTiapanwkahu 11912308001 JT SA¥0 CHITTOOR (R.0) ‘SUBIN-APAP1ena04044337284820°208W Prapery Oaserplon CConsidaratien Price (Rs) Fist Party M RAJENDRA Second Party Not Applicable Paid By (For vwnem) M RAJENDRA Stamp Duty Amounts) 100 {Ge Huncrod ent) V¥ WeACO nae Ue Lil me No. 10-11. 007 of eieag + COURT COMPOUNO,CHITTOOR © ‘CELL: 9177741230 i.e, 04-04-2024 to 04-04-2029 on a monthly rent of Rs, 1000-00 (Rupess One thousand only) per month towards rent in respect of the schedule mentioned shop room for running medical shop. WHEREAS, the Tenant has to pay the Electricity Consumption Charges in respect of the schedule mentioned shop room from to-day onwards to the Electricity Department. WHEREAS, the Tenant has to vacate the said Shop room after the Completion of the lease period of Five (05) Years in good condition and futher the Tensntunder4akes not to sublet the same to any Xgmxe tx thixd parties without the + lek of the Owner. a CMtd—=Po4Bee ae Si Pd Yer 0004233773 ADVOCATE & Ni af Seen aneeal ve “ ‘BID-207 UBS San1N-APT71 19950676026 Date 98-Apr-2004 08:39 AM NEWIMPACG (EVy ee 180004017 AP-CTAY AP-CHTiaganwkahu, 11012300001 JT SAO OHITTOOR (R.0) 5 Folerance | SUBIN-APAPTEeD8040443479019622616W RAJENDRA ‘Considaeation Price (s.) Fist Pary 4 ‘Socond Party 2 Not Applicable oe Paidty (For Whem)—= + M RAJENDRA 100 2 sanpouyanounnpe) + 100 a esanyy % ae \ MURALIOHAS RG i a snes i 2 -3- Schegule, Chittoor District- Kuppam Sub District Beggilapalle Panchayat Gudupalle Mandal - Nalagampalli Village-D.No. 4-163 Ground Floor @ Kuppam to Chittoo¥® Main Road- Shop Room. a g adode Witnesses; i ene TAY 2 foe = "cnaPLAN SHOWING THE EXISTING BUILDING OCCUPIED BY " M/S ANU MEDICALS " R_NO : 4-163, KUPPAN TO CHITTOOR MAIN ROAD, TVILLAGE, SEGGILIPALLE PANCHAY/ IDUPALLE MANDA CHTTTOOR BISTRICT, REFERENCE ‘AREA STATEMENT IN SQM CARPET AREA: 45.29 SQM IN/S ANY MEDICALS cor) 497.50 SQFT iron Mai sian ade - SCALE, 15100 j UNIT : METRES es meDicaL pea = Wad 1 ior Tasca SRE M, RAENORA, 5/0 LATE MUNEEA, SITE OF VENGABPA DN —— e vi 5/0 LATE 1. VENKATESH, CONSULTING CIVIL ENGINEER AS, sat i e ~ JAYA PRailasi,s.en.fiv 4 af CHARTERED ENGINEER i i Fp (Regd. No : M-135305-5) = || 3.5 || 38 , APPROVED VALUER (F.0283) : a LICENCED SURVEYOR 5 3 APOLO ARCHITECTS £2-12/3, Opp. to Collector's Bungaldw Puttur Road, Chittoor, Ph : 94402741. ‘ABPROVAL'S is kupran To cHrrroor main ROAD PLAN (GROUND F1.cOR)eRe me hag 6506s SO: Leake b683 wove aches to Lave dasa om _Qrp-cowire Si bokoassS bm tmotns Engh & Bot SrSo8S DSSEv0 Boginw KogsO. — hz. Sitka 5 i AN av 360 fi Grama Paritiippnsss | 5°HOCUMENTS 10, - DECLARATION OF THE PROPRIETOR/PARTNERIDIRECTORIREGISTERE D. iG PHARMACISI COMPETENT PERSON 1. Shop Name 2 Fpl Mecli als 2. Fall Name (Block Letter) : Jv. VETESH 3 Father/ttusbaned Name fake. TR. Verkabesh P 4. Age sé 5. Permatient Address spinor t-1F-2 Guell pu Ci) 4 CP) KupPany Zmp) chiltooveot 6. Present Residential Address : Do. 7. Educational Qualification : Gohy 8, Details ofearliee eceupation for ‘Last five years = 9. Whether you’ your spouse are in possession : nto of ay Licenses Under Drugs and Cosmetics Rules Eatleror present? if yes, Details YO.Wbethe at ny te Sou / Spouse Drug ile Les cancelled ye, deals {Whether youyour spouse at any sime convicted: @) ‘under any criminal Law? If yes, details 12 anerwihantnds yarousyone: 4 ¢ involved in any Drug Cases? If yes, details 13.Are you / your spouse convicted / acquitted in any cases No : under drugs and Cosmetics Act? If yes, details |4.Are you studied the niles and Regulations of Drugs and ‘Cosmetics Act, 1940 and Rules 1945 and understand ps Responsible ofa eensed eater Ceitify that the above information furnished by me is true and correct and in the case iff any above stated information is found to be false, Ham liable for Criminal Action to be taken by the off the Drugs Control Administration, Andlira Pradesh Place: DateINAP771 04072 14680W ved Date > d-Apr.-2024 0837 AM NEWIMPACC (8¥)/ apt6ogo404/ AP-CTHV AP-CHT/apenwhaby 11012306001 JF SRO CHITTOGA (R.O) Rioforenen > SUBIN-APAPTaOSOModasaTonaHABSOSEW JV TEJESH Property Doser Secor Paty 2 Not Apilcabie aid Bp (For nom JV TEIESH ‘Stamp Duty Amount(As) = (Twenty ) ‘i ideation RAL! VOR ‘STAMP VENDOR Rate to 2028 Eat canroor APPIDAVIT @eclaration of Proprietor) . eee I, J.V.TEIESH, aged qbout 26 yenrs Son of late J.R. Venkatesh, residing at D.No.1-17 Gundlanayanapalli Village and Post, Sudugat? Kuppam Mandal,Chittoor Dist.AP( Aadhaar Card No, 3906 1555 2284 and Mobile No.9346914212) do hereby @eclare for information of the Drug ControliYng Authority that T am the Proprietor of M/S ANU MEDICALS, D.No,4-163, Ground Floor, Kuppam to Chittoor Main Road, Begilapalli Post, Nalagampalli Village,Gudupalle Mandal, Chittoor Dist.AP I have applied tor grant of/Change of Constitution of the Dtug @ Licensé in Porms 20 and 21 in the above named shop to the Drug Controlling Authorities, 0 0004233771 URES) neil? ie alt DVOCATE & NOTARY W027 Wei eet (UB5.) Gandhi Ro. CANTOR S1700r ce "stonets gta Tome I further submitted that if any intormation given by me are found to be false or wrong and the documents submitted by me are found to be false or wrong, I have no objection to cancel our Drug Licences without any notices enquire and that we are also liable for any action taken by the Drug Cont rolling Authorities orGovernment Authorities against me. es . " ' ie My Specimen Signatures. SIGNATURE-DF PROPRIETOR. 29 fe FSURESH BAB! BL ADVOCATE & NOTARY Sitio: 42/2014 410-207, (Ups.) Gandhi Road HITTOOR-S170CL Cell: 940087714 \7_ 04 oly Sony ¥V.SURESHBABU, 3,0. ADVOCATE & NOTARY SLNO: 42/2028 ease Ups.) Gandhi Roat 110 gadone77i¢ax ANU meatal) 2 Full (Bek Lene P.Thula Kumay Lie! ober are P. Chinabba. 9 4. Age a6 ‘ z fo) Gulngpena Puss Cx) phn erg) Chitfoor Co 6. Present Residential Address DO 5. Petmanent Address 7. Educational Qualification : B Phaneneey 8. Details of eartier occupation for Last five years Phanmasiy- 9. Whether you your irstecomnsin: ofan Lene! Unde aat Ral Fair press foe aa {OWhehe tam tine ove Spouse Drug: 4) Hicenses cancelled ? fy details wo 11h oun sue atnymecanide: hs ve minal a a (2tate sewwibanboey yousourouse: gy ~ imedinany Dg Case eee indo econ nce ngs 44 Are you studied the rules and Reputation of Drugs ad Cosmetics At, 1840 and Ras 1943 undone i Respoassilies ofa licensed deter Cestfy that the above sti the Diy above information furnished by me is ed information is found tp he false, | ‘onto! Adnviniistration, true anid correct and in Vsbte for Criminal Action to be tab Anglia Pradesty & P yoni the case if aiything cen bytheSPECIAL DECLARATION OF REGISTERED PHARMACIST 2 Batre Kamar, sioire pchinabba. ageet about ob years, — resid D.No tel 4.-2_Gadllatgyana— Palas Vi) % (Po Kappan __(Mafidal), Chittoor pistrict_ and state oath as follows: 1 am @ Registered Pharmacist/Qualified Person with certificate bearing No. r dt: Silas /2023 t Thave been engaged += as_—=—semployee/Proprietor/Partner/ by Ws._Avl _meclf@iy _and the constitution of the above shop Lv Ty, —__is the proprietor/Partners of the said shop situated at Sm Yoo!) ape Le) Bega te flag det), Chittoor District since dated as full time Registered Pharmacist/Qualified Person. T will not work in any other firm in any capacity as long as 1 continue as the Registered Pharmacist/Qualified Person of M/s. © i Db=162 _byfPam _chittsnr ¢moin voce! _NaSqgarss Patshcvi)- Begs Pollo Jardhoje —Guclu pall Mandal, Chittoor District. Further, 1 deciare that 1 am not doing any further studies in any course in any University after completion of my D. Pharmacy/ B. Phanmacy/. in case ot my leaving the above firm, 1 will give advance notice of one _ month in writing to the licanse holder will mark a copy of the same to = district licensing authority and area Drugs inspector 1 also declare that the above matter herein is true and correct to the best of my, knowledge. If it is found incorrect, the authorities may take legal action against me as per rules. Iwill be held respanable for anything happans during th ‘alat1 HAR? OISSEIOA INAPrrt isisasz925qW7 2 04-Apr-2024 06:96 AM 5 NEWINPACG (SVW/ ap! 6060404 AP-CTRY AP-CHT/apanwkahy 11012908001 JT SFO CHITTOOR (F.0) * SUBIN-APAP1 sosodgaas371700911055W PATHULAS! KUMAR. Proponty Deweripton Consiciration Prise (Fs Second Pay aia By (For Whom) PTHULAS! KUMAR * Stamp Duty Amour) a (Twenty only) No, 10-11-00372010. fo. ttctt-007 of 2026 to 2026 couRT COMPOUND.CHITTOOR CELL ; 9177741230 AEFEIDAVIT (Declaration of Registered Pharmacist /qualified person) . I,PeTHULASI KUMAR, agedebout 26 years Son of PsChYnnabba, residing at D.No.1-17, Gundlanayanapalli Village, & Post, Kupoam Mandal, Chittoor Dist .AP(Aadhaar Card No.6771 5690 1627 and Mobile No,9805657323) do hereby declare as folios: 2. I am a Registered Pharmacist /qualified person with . Certificate bearing No.156783/41 dated 31-03-2023, £ull time employee in M/S ANU MEEICALS, D.No.4-163 G: Floor, Kuppam to Chittoor Main Road, Nalagempalli “illage,Begilapalli Post, Gudupallé Mandal, Chittoor Dist.AP. I will supervise the sales of the Drugs in this shop as reyuired by Rules of the Drugs and Cosemetics Actand Rules thereunder, 2. I w411 not work in any other finn in any capacity as long ae my services in the above shop, In case, I leave the above fim, I will give advance notice to the District Licensing Authority and also to the Shop, A&P gawd entd..p..2.. iN ou foryfroda 0004233770 BAB.L ADVOCATE & NOTARY. SLNB.A2/2012. #10-207;(Ups:y Gandhi Road CHITTOOR-S17001 Cell o4annerts aseas Previously I worked in M/S NIL and tendered my resignation w.e.f. NIL I also declare that the abovematter herein is true and correct to the best of my knowledge and belief. I_wi1l be held responsible for any contravention that happens during the sale of the Drug in this Shop. My Specimen Signatures are given below. Lm) duh My Specimen Signatures, SIGNATURE OF PHARMACIST. 1.55) 9- | 2, ofa wr Pe pug — Witness v Proprietor, 4 s Signal 4 = 1 # 10-207, (Ups.) Gandhi Road CHITTOOR-17001 Cell: 9440087724 ADVOCATE & NOTARY SL.NO: 42/2011 # 10-207, (Ups.) Gandhi Road CHITTOORS17001 Call: 9440087718ee es Se Sts Ste Se, Se Se Se te te Se Me. Ste Se le Se i ed s Sas, & < Amaravati, Andhra Pradesh, India ze = GZBETL S Certeftcate No. 156788 /BL ale of Registration 31-03-2023 This ts to Certify at. Within signed ee. eee Sil Sat P THULAST KUMAR Son / Daaaghor ere P_CHINNABBA hose dale of birth is 20-06-1997 Kas boon dabg | Pranmacy Act 1948 (8th of 1948) Th witness where of are hercwith aofficed the sealPharmacist Name : Registration No P THULASI KUMAR 156788 /Al SNo Place Of Work / Study Working As From To RemarksCNN GN AN GN NON WN WN NON NWN WN AN ON ENON ON GV GN GN GN AN ON GN GV GN ON GY ANG. «STRA COLLEGE OF PHARMACEUTICAL EDUCATION & RESEARCH Approved by AICTE & PCI, New Delhi, Affiliated to JNTUA, Anantapur Managed by Venkateswara Educational Society Varigonda Village, T.P. Gudur Mandal, Nellore Dist., A.P. Pin: 524 311. TRANSFER AND CONDUCT CERTIFICATE s.no.: 003 Agmission No. 13 +9. Roll No. Ay Yi. Roodd Name of the Student in full Poss Kuaae {in Block Letters) Name of the Father : P_cu INNARRA Nationality : SINDIAN Religion : HinOu ‘Community c Sex:__MALE Date of Birth as entered in the Admission Register Boles yoo (Both in figures and words) ~Thoe ZERo = ZERn Sin one nine Nuns Seven) Admitted on roliol dow into_ “13. PHARMACY Course bate otteeving the Cotoge oe higlangt The course from which he/she leaves SB PHAR MACY 2 Whether qualified for next higher course = - Whether he/she paid as dues to the College Conduct and Character Date : ot | \2|20}b> Mar awe S07 crm, un CUOLANAYANAPALLL ‘GUOLANAYANA PALL MIC Kappan, PO: Kuypan Pri coee siz. he nS > & ems / Your Aachaar No. : ELE eyerament of India _ ‘fgsS/ Enriment No. 0000/00! 26/46065 6771 5690 1627 “Ml: aise 9497 8160 9408 5, m coQ0R> * ei soearn temp aropmnra pas Ronis pete ry = jeveobeocttasts ewoscuauan se anda De nce Retey concer ony aren er sore anf eatoen te hecomeesence Sate abenoe vot ajaes andy atense, 1 yo cara ods ant 0 0. oy ‘Stas Somers sues oped cee 1 Dts gs tts sages get erenrhcues eae? wvsbeo toveeced B Daued aah acts ¢ seus abt wot Ses cfed Wo Neues Oteces whatanr aos EOE Ses, * Soe wese Po mages am,btor mage Dracus entice Sr pa 1 oar aa a 1 Occumens 9 ager ey rd ase she be pate ‘stone ere 6 yu an if ast a (© Seer nbn oun cs Gover Nr ‘Grvermarttonceaencae 1 raspy moti runoe end ana pet hac | Croat nec 790 mato! Areca ‘© Un be neue canoe Aitonets oa sone ws ing Aachen (= ten sotng Anca ata eek co.