GPTP/ CFC

CIN.- U74140DL2010PTC201479

GLOBAL PT PROVIDER PVT. LTD.

CUSTOMERS FEEDBACK FORM

Company Name:

Contact Person Name:

Address:

Service used:

PT Scheme Name & Code:

PT Test Item Details:

(Parameters etc. tested)

PT Service: (Please Tick Appropriate)

(a) Very Satisfactory
(b) Satisfactory
(C) Unsatisfactory

Fees for Proficiency Testing:

(a) High
(b) Satisfactory
(c) Low

Appeals (if any):

a. Material preparation
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b. Homogeneity-
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Issue No.:00 Global PT Provider Pvt. Ltd. Rev. No.:01

Issue Date: 15/11/2012 E-41, Okhla Industrial Area, Phase II Rev. Date:00
New Delhi 110020
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 GPTP/ CFC
CIN.- U74140DL2010PTC201479

c. Stability of material (where applicable);

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d. Performance Evaluation;

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e. Damage or lost of PT items.

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Suggestions (if any):

Complaints (if any):

Signature:

Name & Designation:

Date:
(Company Sealed:)

Issue No.:00 Global PT Provider Pvt. Ltd. Rev. No.:01

Issue Date: 15/11/2012 E-41, Okhla Industrial Area, Phase II Rev. Date:00
New Delhi 110020
Page 2 of 2