Customer Name * Customer Phone/Fax/Email * Customer Address Contact Name Contact Position Customer P.O. No. Invoice/D.N Number Product Code Product Description Complaint Reference # (of customer) If any Check all that apply: wrong-itemsdamaged-itemsquantity-mismatchdelayed-deliverymissing-documentsproduct-quality Details if any: Message
Lab Division
Surgical & Cardiovascular Division
Medical Division
