Pharma Bulk Purchase Requirement Form
Please fill the form for procurement of good quality Pharma Products/ Customised Face Mask for your hospital- the products will be available at 20-30 % of MRP and produced in Factories which manufacture the products for leading brands in the market today.
Conditions
1) Minimum Order Quantity - 200 Units per product
2) Manufacturing time 6-8  weeks
3) Payment 100% in Advance
4) Taxes and Transport costs will be extra
5) Product Expiry will be More than 18 months except proparacaine

( Returning or Logged in Users - Please input only the product Requirement alone)
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Email *
Your Name
Hospital/Pharmacy Name *
Billing Address( Please mention Complete Address with Pincode etc for delivery of the products)
GST Number( Mention Nil if No GST) *
Drug License Number ( Mention Medical Registration Number if No Drug Licence)
Contact Person Name and Mob Number
E mail address
Product Required- ( Minimum Quantity 200 Units) Please select product of Interest alone
200 Units
300 Units
400 Units
More than 400 Units
Flurbiprofen Sodium USP 0.03% HPMC 0.025% Phenyl mercuric Nitrate 0.002% MRP Rs.50/- Offer price Rs.18.40
Sod. Carboxymethyl Cellulose 0.5% Stabalized Oxychloro Comples 0.005% MRP Rs.140/- Offer price Rs.25
Moxifloxacin Hydrochloride 0.5% Loteprednol Etabonate 0.5% MRP Rs.140/- Offer price Rs.44
Moxifloxacin 0.5% MRP Rs.105/- Offer price Rs.21 (without preservative)
Moxifloxacin Hydrochloride 0.5% Dexa. Sod. Phosphate 0.1% MRP Rs.80/- Offer price Rs.23.00
Natamycin 5% MRP Rs.95/- Offer price Rs.35
Nepafanac 0.1% MRP Rs.140/- Offer price Rs.38
Ofloxacin 0.3% MRP Rs.60/- Offer price Rs.19
Ofloxacin 0.3% + Dexa. Sod. 0.1% HPMC 25% MRP Rs.40/- Offer price Rs.17
Olopatadine HCL 0.2% MRP Rs.160/- Offer price Rs.29
Napha. Hcl 0.1% , HPMC 0.1%, CPM 0.01% Boric Acid 1.25% MRP Rs.60/- Offer price Rs.19
Napha 0.1%+ CPM 0.01% Methyl Cellulose 0.2% MRP Rs.75/- Offer price Rs.24
Clear selection
Do you Require Customised  3 Ply Melt Blown Face Mask with Hospital Name -Minimum Quantity 1000 Pieces- Cost Per Unit is 2.50 ( Including GST) Transport cost Extra- Mention How much quantity you require 1000,2000,3000 or more
Are you a Member of Ophthall Buying Group- Please mention your OBG Code- If not yet a member Log on to www.ophthall.in/login to generate your code
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