附表3

中华人民共和国药品监督行政执法文书

 

                                                         ( 举登[ ]


举报人:                                联系方式:                  

举报形式:                                  间:                  


举报内容:

 

 

 

 

 

 

 

                                       记录人:              

                                                      


处理意见:

 

 

 

                                       负责人: