DELIVERY CHALLAN

To, D.C. No.:

Date :

Dear Sir,

The following material is being dispatched against your Work order no: , Dated: , this is a part
shipment of the above work order mentioned. Please receive these items and return the duplicate copy of the DC duly
signed and stamped.

Item No. Description UOM QTY

Received the above mentioned Checked by For ____________________

Items in good condition

Receiver’s Signature with Stamp Signature Designation