Schedule- 2
(Relating to Clause (a) of Rule 7)
Name and address of the owner of food:
I have, on the date, taken from the shop/godown/house and compound of … … …
… located at… … …, a sample of the below-mentioned food for analysis.
Description of food:
… … … … …
Area … … … …
Place: Food Inspector
Date: … … … …