Register a Complaint - Indian Pharmaceutical Alliance

Fill out the below form to register a complaint. A non-refundable amount of Rs 1000/- (Including GST) is to be deposited for registering a complaint.

Name: *

Email: *

Phone: *

Organisation: *

State *

City *

Pincode *

GST No.

Types of Complaints *

Nature of Complainant *

Address *

Complaint *

Upload Document *

Upload Supporting Documents Allowed files: .doc, .docx .xlsx, .xls, pdf, jpg, png formats (Allowed File size: less than 2MB).

I hereby declare that the above information is true & correct to the best of my knowledge and belief.