MEDI-CARE PRODUCTS Sdn. Bhd.

(17755-T)
EXECUTIVE OFFICE: IPOH: 30A, Lorong Taman Ipoh Satu, Ipoh Garden South, 31400, Ipoh, Perak. Tel: +605 5457814, 5452248, 5471343
Fax: +605 5475520
Sales Office: USJ: LOT 21-2, Subang Business Centre, Jalan USJ 9/50, UEP Subang Jaya, 47620 Selangor Darul Ehsan.
Tel: +603 8023351, 80233175 Fax: +603 80235803
PENANG: 38, Jalan Kuantan, Mezzanine Floor, 10150 Penang. Tel: +604 2292981 Fax: +604 2281509
KUCHING: 753, Lorong 3C-1C, Jalan Song, 93350 Kuching, Sarawak. Tel/Fax: +6082 369233

COMPLAIN FORM 3M REF NO:

Department Information
Complain date: 01/6/2021 Date Send to 3M: 10/6/2021
Hospital name: POLIKLINIK FASYA Department:
Complainer name: NUR FARHANA BINTI HAMZAH Position & Title: PIC/OWNER/DOCTOR INCHARGE
Email: poliklinikfasya@gmail.com Phone Number: 0137080963 Ext:
H/P Number:
Product Details
Description of Product:
3M LITTMAN ELECTRONIC STETOSCOPE 3200

Catalogue/Stock Number: Batch/LOT/PO Number:

Note: Do not discard the product if contaminated, place the item in a sealed container and retain.

Quantity: 1
Faulty product available for investigation: YES NO
Action Taken Credit Note Replacement
Picture of faulty product YES NO
Need 3M to visit YES NO
Rectify and solve YES NO

State reason if NO:

Complainer Signature: Handle By:

DETAIL DESCRIPTION OF COMPLAINT

MEDI-CARE PRODUCTS Sdn Bhd USE ONLY

Complaint Handled by: Date:

Comment:

Action Taken Credit Note Replacement

Date:

Feedback to department Date: Person in-charge:

MANAGEMENT USE ONLY

Action Taken: