Plot No. 363-364, G.I.D.C, Makarpura Opp.
Hanuman Mandir,
Behind Sajanand ArcadeVadodara,
Gujarat, India. 390010 Call: +91- 6358814447
CUSTOMER COMPLAINT FORM
CUSTOMER INFORMATION
COMPANY NAME:
COMPLAINANT: CONTACT NO:
DATE OF COMPLAINT: MODE TIME: DATE:
PHONE
EMAIL
BUNKHOUSE AGREEMENT No. SIZE OF UNIT
CODE NO: ON HIRE
UNIT ON SALE
CHALLAN No.
WITH DATE
PRESENT LOCATION CONTACT PERSON AT SITE:
OF BUNKHOUSE PHONE No.
SITE ADDRESS:
COMPLAINT NAME: DATE & TIME PHONE No.
REGISTERED BY REGISTERED REGISTER
{RBMPL} {FOLIO}
No.
COMPLAINT INFORMATION
COMPLAINT
DETAIL:
COMPLAINT GATE PASS NO:
ATTENDING
PERSON:
COMPLAINT DATE TIME: SERVICE CHARGE YES NO
RESOLVED:
ADDITIONAL YES TYPE OF MATERIAL [DESCRIPTION]
MATERIALS
REQUIRED FOR
REPAIR NO
CHARGEBALE
TO PARTY.
FEEDBACK:
ACCOUNTS DEPARTMENT SIGNATURE:___________________________________
AUTHORISED SIGNATURE:____________________________________
Plot No. 363-364, G.I.D.C, Makarpura Opp. Hanuman Mandir,
Behind Sajanand ArcadeVadodara,
Gujarat, India. 390010 Call: +91- 6358814447
ACCOUNTS DEPARTMENT SIGNATURE:___________________________________
AUTHORISED SIGNATURE:____________________________________