FORM M.RD
(See rule 13)
Licence No
(See rule 13)
Licence No
Licence is hereby granted under and subject to the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made there under to of (herein after referred to as " medical practitioner" person-in-charge) on payment of a licence fee 1[of ]1 authorising him to dispense spirituous medicinal preparation at his dispensary, the hospital or dispensary situated at (herein after referred to as "the licensed premises") during the period from to subject to the following conditions, namely :—
Date:
Seal of the Collector
Collector of
1. Subs. by G.N. of 24-1-1959.
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