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BREAK DOWN INTIMATION

Forwarded To: Chief Warden

Dated:____________________
Category of Complaint(Immediate/Urgent/Ordinary)__________________________________________
Location______________________________________________________________________________
Complaint_____________________________________________________________________________
____________________________________________________________________________
Name of Operator deputed_______________________________________________________________
Work completed : (Yes/No)_______________________________________________________________
If not completed(WHY):__________________________________________________________________
_________________________________________________________________
Signature of Operator(With remarks OK/Not OK) _____________________________________________
Signature of the Complainer______________________________________________________________

BREAK DOWN INTIMATION

Forwarded To: Chief Warden

Dated:____________________
Category of Complaint(Immediate/Urgent/Ordinary)__________________________________________
Location______________________________________________________________________________
Complaint_____________________________________________________________________________
____________________________________________________________________________
Name of Operator deputed_______________________________________________________________
Work completed : (Yes/No)_______________________________________________________________
If not completed(WHY):__________________________________________________________________
_________________________________________________________________
Signature of Operator(With remarks OK/Not OK) _____________________________________________
Signature of the Complainer______________________________________________________________

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