The document is a request form submitted by a field person to their branch manager seeking approval to provide products to a doctor. It includes details of the doctor such as name, specialization, last two visit dates, current and expected business. It lists the requested products and quantities along with whether it is a monthly or SOS requirement. The branch manager approves the request and comments that providing this service can gain better support from the doctor as they are potential for the company's products.

1. NBM
REQUEST FORM FOR DOCTORS REQUIREMENT
Without MSL code/visit dates of the doctor, your request cannot be approved.
EMP ID.
: 85408
NAME OF FIELD PERSON: RAM SEVAK YADAV
Designation
: TM
Date: 15/10/2013
HQ
: BANGALORE
TASK FORCE: GTF
MSL code
: 0131564
Patch No: 3
Doctor’s name
: DR VIJAY KUMAR B.A
Spcl/Ctg : PHY/A+
Last two visits date: 1ST OCT & 11TH OCT
Current Business : 6000
Expected Business: 7500
Address
: NO.63, EAT STREET, BASAVANAGUDI, BANGALORE 560004
MOB: 9019324325
Mobile / Telephone no of Dr: Product Requirement
SL.NO
PRODUCT
QUANTITY
1
RABICIP 20 MG
30 TAB
2.
LEVOFLOX 500 MG
20 TAB
Requirement type:
(Please write Yes/No)
Monthly:
PLEASE APPROVE IT.
B. M .Name
: Mr. Ashok G. Nolvi
B.M APPROVAL: ok approved
yes
SOS: yes

2. Comments by BM: - doctor is potential for Spectra care product and after giving
this service we can get better support from the doctor.