动物源物料调查问卷.doc

No. Animal Resource Material Questionnaire 动物源物料调查问卷MATERIAL NAME (Brand Name Generic Name): 物料名称（商品名通用名） MFG COMPANY NAME : 生产厂名称： MFG COMPANY ADRESS: 生产厂地址： CONTACT NAME/TITLE: 联系人姓名/职位： CONTACT INFORMATION： (Telephone No., Fax No., Email address) 联系信息（电话，传真，电子邮件） Notice: 注意： In the interest of a consistent evaluation, the responder is requested to adhere quite accurately to the respective questions. Missing or unfounded answers would lead to call backs or deductions. 为了评估的完整性，回答者应对相应问题附加附件，没有答复或无根据的答复将导致退回或降级。 The responder is free to supply any additional information that could support the interest and the capabilities of his company. This information is to be added to the questionnaire in the attachment.. 回答者可以提供任何能够支持公司利益或能力的附加信息。这些信息可以填加在附件中。1 Are the starting materials of the product partly or fully of animal or human origin?(e.g. tissue, tissue extract or fluid such as milk, serum, blood)原材料是部分或全部来源于动物或人？（例如，组织，组织提取物或液体，例如牛奶，血清，血液等） ?? Yes 是 ? ? No 否 If NO, specify the origin of the starting materials 如果否，请指出原材料的来源 ?? Vegetable 植物 ?? Synthetic 合成 ?? Fermentation/cell culture origin without any animal or human derived product in the broth 没使用人或动物来源的培养基的发酵或细胞培养 ? Inorganic 无机的 Other (please specify)其他（请说明）: 2 Are other materials (also reagents like chromatographic media, buffers etc.) of animal or human origin used in the manufacturing process of the product?是否在产品生产过程中使用了其他人或动物来源物料（包括试剂，例如色谱溶媒，缓冲液等）。? Yes 是 ? No 否If YES, specify 如果是，请说明: 3 Are there procedures in place to avoid cross-contamination with residue of animal or human origin materials that come into contact with the equipment used for manufacture of the product (e.g. other products and/or cleaning or disinfecting agents, media fills)?在生产过程中是否采取了避免人或动物来源物料残留对使用该设备生产的物料的交叉污染（例如其他产品，和/或清洁剂或消毒剂，溶媒）？ ? Yes 是 ? No 否 ?? Not applicable(i.e., no animal/human origin materials come into contact with the equipment) 不适用（例如，没有人或动物来源物料接触设