CORRECTIVE / PREVENTIVE ACTION REPORT
Non-Conformity/ Customer Complaint Ref.: DT:
Part No.: Rev No: Description: Qty:
Functional area to which NC is attributed
Supplier :
(Source):
Description of Non-Conformity:
Disposal Action: Rework / Regrade / Concession / Repair / Scrap
Document Reference:
Root Cause Analysis & Verification: Consider Man,Machine,Method,Material for each cause
Occurrence Root Cause ( The cause which makes the problem occur)
Escape Root Cause ( The cause which has allowed the problem to go undetected to the customer)
System Root Cause ( System cause is one allows the Escape and Occur Causes to occur)
Corrective Action to be Taken Function Impleme
[Link]. Date
Based on above analysis Responsible nted On
Risk Assessment review required : Yes / No
If Yes, Remarks:
Review of Corrective action : Verify related Documents and Records
Reviewed By: Date:
Effectiveness monitoring:
Closed By: Date: