Kurasi Kosmetik dan Herbal

1
Tanggal Kurasi* This field is required.
Date
Year
Month
Day
2
Email
contoh@contoh.com
3
Nama Pelaku Usaha (Sesuai KTP)* This field is required.
4
Alamat seuai KTP* This field is required.
5
Nomer Telp (Whatsapp)
6
Nama Produk (Branding Produk)* This field is required.
7
Jenis Produk* This field is required.
Kosmetik
obat obatan
Herbal
Lainya
8
Legalitas* This field is required.
Nomer Induk Berusaha
HKI
BPOM
Other
9
Foto Produk* This field is required.
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Select files to upload
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Mencari File
Cancelof
10
Omset Produksi/ Bulan
11
Omset Penjualan/ Bulan
12
Harga Grosir
13
Harga Eceran
14
Tim Kurasi 1* This field is required.
Siti Jamilah, SH
Eni Hidayati,SP
Zahrotun Nisa Utami, SE
Dwi Puji Astuti, SE
Nurhadi Rahmanto, SE
Isnaini Khoirun Nisa, SE
15
Tim Kurasi 2* This field is required.
Siti Jamilah, SH
Eni Hidayati,SP
Zahrotun Nisa Utami, SE
Dwi Puji Astuti, SE
Nurhadi Rahmanto, SE
Isnaini Khoirun Nisa, SE
16
Tim Kurasi 3* This field is required.
Siti Jamilah, SH
Eni Hidayati,SP
Zahrotun Nisa Utami, SE
Dwi Puji Astuti, SE
Nurhadi Rahmanto, SE
Isnaini Khoirun Nisa, SE
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Kurasi Kosmetik dan Herbal