MOCK RECALL LOG

Section A: Initiation
Mock Recall No.: Initiation Date:
Customer: Location:
PRODUCT DETAILS
Product Description Specification Batch Code/Lot Code

Source Code: Lot Size: D.R No.: P.O No.:

Additional information:

Section B. Contact details of Mock Recall coordination committee

Item No. Name Designation Mobile No.

10

Initiated by: Reviewed by: Approved by:

_______________________ _______________________ _______________________

Signature Over Printed Name/Date Signature Over Printed Name/Date Signature Over Printed Name/Date
 Section C: Mock Recall Intimation

Mock Recall No. Date:

Product Description Specification Batch No./Lot No.

Total Volume Produced: Manufacturing Date:

RM Details
RM Used: Lot No.: Quantity used:
Quantity Received: Remaining Stocks:

Part A (To be filled by Logistics/Warehouse Personnel)

Received Quantity from Production: ______________________________________________
Quantity Released for distribution/in transit: ________________________________________
Location Dispatch Quantity Delivery Receipt No. Delivery Date

Total:
Part B (Details from customer)
Stock Details
Product Name
Batch no./Lot no.
Quantity Received (pc/kg)
Quantity Used (pc/kg)
Remaining Stocks (pc/kg)

Section D: Mock Recall Communication:

Please use a separate sheet if needed

Means of Communication (Phone, Fax,
Communicated to Contact No. E-mail, other means)

Conducted by: Verified by:

Signature Over Printed Name/Date