PHYSICAL VERIFICATION REPORT

Form No -19(para 10.12) To be filled in Triplicate

1. Institution : 5. Stock taking on :

2. Department/Section : 6. Office order no /Date:
3. Type of Stock : 7. Actual verification date from to
4. Person in charge : 8. Verifying officer name:

Designation: ......................................................... Designation: .................................................................

Book Value Actual value Shortage Excess Remarks
Stock Ref
Description of Article Quantity in
Ledger No Folio No Price/Unit Value Quantity Price/Unit Value Quantity Value Quantity Value
Ledger

1 2 3 4 5 6 7 8 9 10 11 12 13

Certified that all Stock & Store have been produced correctly & truly for verification and duly verified.

Person In-Charge Officer In-charge of the dept/Section Verifying Officer Head of the Institution

B: Col 1 to 5 are to be filled by the person in charge & Col. 6 to 13 are to be filled by the Verifying Officer