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Template of the Manufacturer's Serial Release Test Report to VBS

Manufacturer's Serial Release Test Report to VBS

Company Name
Establishment Licence Number
Address
Telephone - Fax

Assigned Name:

Trade Name:

Production Outline Dated:

VBS Product File Number:

Serial or Sub-Serial Number:

Expiration Date:

Fill Date:

No. of Containers:

Container Size (doses, mL or units):

Total Number of Doses or Kits:


Code:	S = Satisfactory I = Inconclusive	U = Unsatisfactory N = No Test

Disposition by Manufacturer:

VBS Product File Number:

Serial Number:

Eligible for release:

Destroyed:

Other:

Date:

Signature:

Disposition by Veterinary Biologics Section:

Not to be tested:

Test completed, satisfactory:

Test completed, unsatisfactory:

Other:

Eligible for release:

Not eligible for release:

Date:

Signature: