TEST REQUEST FORM

Company Details

Name of Company:*

Address:*

GSTIN No.:*

Date of Test Request:*

Company Ref. No. / PO No

Name & Designation of Representative filling this form:*

Mobile No:*

Email Address:*

Details of the Sample submitted to be tested

No.:*

Identification / Embossing / Printing on Sample:*

Sample Description:*

Remarks:*

Length of Sample:*

Tests Required to be done

Name of Test(s):*

Test Method/Specification:*

Any other specific condition:*

YesNo

Same AsAs Mentioned below

Same AsAs Mentioned below

Signature of Customer Representative