Complaint Form
Fields marked with * are mandatory
Brand Name:
*
Product Name:
*
Pack Size/Net weight:
*
Batch No:
*
Packed on/ Packaging date:
*
Manufacturing Address:
Purchased on (date):
Purchased from (store name):
Is bill present with the customer?
Yes
No
Whether sample available with consumer?
Yes
No
Whether sample is sealed?
Yes
No
Has product been consumed?
Yes
No
Complaint* (kindly provide complete description of
the complaint):
*
Contact Details- Name:
*
Phone No:
*
Mobile No:
*
Email:
*
Address: (with city name and pin code)
*
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