Product related problem:

• Provide the reason of lodging this product complaint by checking the appropriate box like whether the product was unstable when in use (i.e. there was change in colour or sedimentation seen), contaminated or was a counterfeit product, product didn’t work or product confusion (by name, labeling, design or packaging), labeling problems caused by printing errors or omissions . If complaint is any other than this please specify the complaint in space provided.
  
• Only one adverse event/side effect should be reported in one form. If more than one adverse event/side effect, use another form
  
• Indicate whether the event you are going to report is adverse event/side effect of a product complaint or a others like product use error
  

• Enter the date and time of onset of adverse event/side effect, date and time of end of adverse event (if the adverse event is stopped). If accurate dates are not known please provide the approximate duration of the event.