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Insecticides Rules, 1971

FORM IX

REPORT OF INSECTICIDE ANALYST
[Rule 24(3)]

1. Name of the insecticide inspector from whom received:

2. Serial No. and date of Insecticide Inspector#$#s Memorandum:

3. Number of sample:

4. Date of receipt:

5. Name of the insecticide purporting to be contained in the sample:

6. Condition of the sales on the package:

7. Result of test or an analysis with protocols of test applied:

Insecticide Analyst.

Date.__________________

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