CMADP

Instructions for CMADP Form

Application for Participation in Chief Minister Affordable Drug Program (CMADP)

Full Name

Passport-size photo

Image size must be 3.5 x 4.5 cm (35x45 mm)

Educational Qualification

Attach copy of certificate

Please upload compiled document if more than one

Previous work or business experience

Attach supporting documents

Please upload compiled document if more than one

PAN/GST Number

Attach copy of PAN/GST Number

Any Bank loans availed for business purposes?

Details of Such Loans

Preferred location for setting up a pharmacy Preferred location for pharmacy

Name of village, locality and block

District

Phone number

Email ID

I hereby declare that all the information provided above is true to the best of my knowledge. I understand that any false information provided may lead to disqualification from participating in the Chief Minister Affordable Drug Program (CMADP).

Upload Signature

Image size must be 3.5 x 4.5 cm (35x45 mm)

Date

Please ensure to fill out all the required details accurately and attach the necessary documents as mentioned in the application format. This format should be used for submitting your application for participation in the CMADP.