Biotech Park - Lucknow

Name of requisitioner *
Name of the person to be contacted *
Institute/ Company *
Billing Address *
Email *		Fax
Phone *		Date *


Sr.No. *	Material to be processed *	Quantity *	% Bioactive compound (as per analysis report) *






Equipment's to be used (Please Click Here for process charges) *
Solid Solvent Extraction Unit Rotatory Evaporator Falling Film Evaporator Column Chromatography Oil fired Steam Boiler Others Please Specify

Material can be delivered to Biotech Park or sent through courier/transporter at the address provided below. Biotech Park, Sec-G, Jankipuram, Kursi Road, Lucknow - 226021 (U.P.), India Tel.+91 522 4012091, 2365050 Mob:9454385558

Signature of the authorized person of the company/Research supervisor: