Health Department 42[FORM 19-AA [See Rule 62-C] Application for grant or renewal of a 42a[licence to sell, stock or exhibit or offer for sale by wholesale or distribute] drugs from a motor vehicle 1. I/We .........of.........hereby apply for 42a[licence to sell, stock or exhibit or offer for sale by wholesale, or distribute] drugs specified in Schedules C and C(1) and /or drugs other than those specified in Schedule C and Schedule C(1) from the vehicle bearing registration No . . . . . assigned under the Motor Vehicles Act, 1939. 2. Categories of drugs to be sold/distributed ---..................................... ..................................... ..................................... 3. A fee of rupees ..................... has been credited to Government under the head of account .................. *4. Particulars of the storage accommodation for the storage of drugs specified in Schedules C and C(1) on the vehicle referred to above. Date......... Signature........] * Delete if not required.
