This is the Form 28 and you will have to contact the State Licensing Authoritiies. Refer the attachment for details and for your state, Karnataka, contact -
Drugs Controller, Drug Control Department, PB No.5377,
Palace Road,BANGALORE-560001
Phone - (080)22262846, 22282789, 22256386, 9449818892
Fax - (080) 22286492
.