【正文】
stration: Positions: Tel: Fax: Email: Legal Representative (Signatures): (Department Official Seal) Month Day, Year22 Institutions 4 (Registration Agency of Imported Drugs):This agency is responsible for payment Chinese Name: English Name: Organization Code: Legal Representative: Position: Registered Address: Zip Code: Contact Address: Zip Code: Head of an Application for Registration: Position: Contact: Position: Phone : Fax : Email: phone: Legal Representative (Signatures): (Department Official Seal) Month Day, Year 23 Items list for this application:AuthoritiesAfter reviewed, the table is in line with the form with the request.Authorities: Reviewer (Signatures) Date: