FORM NO. 6
(See rule 67)

Date and time of despatch of the consignment.
1.  Name and address of consignor (manufacturer/dealer/distributor and his Licence No. etc. (Issued under the Drugs and Cosmetics Rules, 1945).
2.  Name and address of the consignee (manufacturer/dealer/distributor) and his Licence No. (Issued under the Drugs and Cosmetics Rules, 1945).
3.  Description and quantity of the consignment.
(a) (b) (c)
Particulars of the drugs with reference to the No. of packages. Quantity
Schedule(s) to the 1945 Rules, Trade Marks; Gross Net Patent and Proprietary Names, etc.
4. Mode of transport (Particulars of the transporter, Registration Number of the vehicle, R.R. if the Transport is by Railway, etc.,)
5.  Date and time of receipt by the consignee and his remarks.
NOTE
Signature of the consignee with date Signature of the Consignor with date
(Name in capital letters) (Name in capital letters)
(1)  This Consignment Note should be serially numbered on annual basis.
(2) The Consignor should record a Certificate on the cover page contained in such consignment note-book.
(3) The Consignor should maintain a Register showing the details of the books of consignment notes brought in use during a particular year.
(4)  The books containing consignment not used or currently under use and the register as referred to at item (3) have to shall be produced to the officers whenever called upon during the course of their inspections