Pharmaniaga’s Complaint Form

COMPLAINTS MANUAL SUBMISSION

    Sector*
    GovernmentPrivateInstitution
    Product Name*
    Product Code*
    Batch No.*
    Supplier / Manufacturer*
    Expiry Date*
    Affected Quantity*
    Delivery Order No.*
    Complaint Details*
    ProductItem Delivery / AcceptanceOthers

    [group group-complainproduct]

    Product*
    DrugMedical DeviceRaw Material

    [/group]

    [group group-complainitemdelivery]

    Short SuppliedOver SuppliedDamagedWrongly SuppliedItem Not ReceivedWrongly DeliveredOthers

    [/group]

    Complaint Description*
    Replacement*
    RequiredNot required
    Attachment*
    Complainant Details
    Name*
    Position*
    Organization*
    Phone No.*
    Email*