FORM A-II
[See rule 8]
Monthly return showing liquor received and used for the manufacture of spirituous medicinal preparation and/or toilet preparations for the month of............................
Licence No. ................................................
Name of the licensee................................................................................................
Period of the licence
| Opening balance Quantity purchased or received | Quantity used | ||
|---|---|---|---|
| Kind of liquor (1) | Quantity liquor (2) | Kind of liquor (3) | Quantity Total of columns (1) and (2) (4) |
Medicinal or toilet preparation manufactured
| Closing balance | Preparation | Liquor used for the said preparation | Remarks | |||
|---|---|---|---|---|---|---|
| Kind of liquor (5) | Quantity liquor (6) | Name (7) | Quantity liquor | Kind of liquor | Quantity | |
Signature of the Licensee