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STANDARDIZATION DOCUMENT IMPROVEMENT PROPOSAL (See Instructions- Reverse Side) |
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1. DOCUMENT NUMBER A-A-51046A |
2. DOCUMENT TITLE CIMETIDINE TABLETS, USP |
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3a. NAME OF SUBMITTING ORGANIZATION |
4. TYPE OF ORGANIZATION (Mark one) ○ VENDOR ○ USER ○ MANUFACTURER ○ OTHER (Specify) __________ |
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b. ADDRESS (Street, City, State, ZIP Code) |
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5. PROBLEM AREAS
a. Paragraph Number and Wording
b. Recommended Wording
c. Reason/Rationale for Recommendation |
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6. REMARKS
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7a. NAME OF SUBMITTER(Last, First, Mi- Optional) |
b. WORK TELEPHONE NUMBER (Include Area Code- Optional) |
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c. MAILING ADDRESS (Street, City, State, Zip Code- Optional) |
8. DATE OF SUBMISSION (YYMMDD) |
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