TAMILNADU MEDICAL SERVICES CORPORATION LIMITED
417, Second floor, Pantheon Road, Egmore
Chennai-600 008. India
Phone: 91-44-28191890, 28190259 Fax:91-44-28190636
 
Company name : _______________________________________________________
Date of incorporation : ____________________
Company Address : _______________________________________________________

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Company Phoneno : ________________________________
Company website : _______________________________________________________
Type: Proprietor / Partnership / Limited company
Telephone No : ________________________________
Mobile No : ________________________________
Fax No: ________________________________
Mailid of MD / CEO _______________________________________________________
Annual Turnover Last 3 Years :
Sl.No Year Amt (in Crores)
1.   Rs.
2.   Rs.
3.   Rs.
Details of licence renewed upto date : ________________________
Importer licence renewed upto date : ________________________
Product List :  
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  (Signature with company seal)