FORM A

Bombay Prohibition Act, 1949 [1949 : Bom. XXV 1 FORM ‘A’ [See rule 19 (2)] Register of accounts of spirituous medicinal pr eparations received and sold by a person holding a licence in Form S. M. P. I No.during the month of . . . . . . . . . . . . . . . . . 20 . Name of the Licence................................................................................................................................................................ Address .................................................................................................................................................................................. Name of the spirituous medicinal preparation ........................................................................................................................... –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– DateOpeningQuantityFrom whomTotalQuantity soldTo whom soldClosingSignature ofRemarks balancereceived received[Columns (2)balancethe licensee and (3) ] (1) (2) (3) (4) (5) (6) (7) (8) (9)(10) –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1.Ins.by G. N. of 14-7-1962.