Reporting of Technical Complaints "*" indicates required fields Designation of Person Recording the Complaint*PharmacistPharmacist AssistantRepresentativeDoctorPatientName of Pharmacy/Doctors Surgery* Name of Person Reporting the Complaint* Email Address - Customer* Telephone Number - Customer*Date Complaint is being reported* MM slash DD slash YYYY Name of Product* Strength of Product* Pack Size of Product*30 capsules60 capsulesBatch Number of Product* Expiry Date of Product* MM slash DD slash YYYY Description of the complaint in detail*Does the patient still have the product?YesNoIs the patient able to provide pictures*YesNoFile UploadMax. file size: 64 MB.