NONCONFORMANCE REPORT (NCR) 5R AUDIT

Production Department
PT Metiska Farma

Auditor :

Identification
Audit Date :

Auditee :

Report Number :

Area :
Nonconformance Description

Risk Level : Major/ Minor

Root Cause Analysis

Corrective/Preventive Action
Corrective and Preventive Action Required

Completion Date

PIC

Verification of Completion

Status :

Person Responsible for the Corrective/Preventive

Action (Auditee)

CLOSE/ OPEN
Approval of Corrective/Preventive Action (Auditor)

______________________________________________
Name
Date
_________________________________________
Name
Date
Closing the Nonconformance
5R Officer

5R Advisor

_________________________________________
Name
Date

______________________________________________
Name
Date

Distribution:
- Head of Division
- 5R secretariat