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Advanced Metrology

Calibration Laboratory
‫مؤسسة القياس المتقدم‬
‫مختبر المعايرة‬

F/QMS/18
Calibration Service Request UUT Receipt form Issue
No.04
Sr. No.  Date 
Name and Address of Customer: Tel. Nos. 

Ref. No. And Date 


Details Of UUT Received For Calibration
Sr.
Scope Accuracy/ Cal. Partial /
No DESCRIPTION Range Qty
A / NA L.C. Full
.
1.
Calibration Validity 
Accessories, If Any 
Condition Of UUT During receipt
Calibration  Full / Partial
Reason For Partial Calibration 
Document Submitted 
A  Accredited Parameter NA  Non Accredited Parameter
Terms And Condition As Overleaf
I / we agree the details and terms and conditions as mentioned for calibration.
Signature Of Customer
Date 

Instrument Received Duly Calibrated


Form Issued By (sign.) Service Closed On

Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬


P.O.Box 77143 Dammam ٣١٩٥٢ ‫ الدمام‬٧٧١٤٣ ‫ب‬.‫ص‬
31952 ٠١٣ -٨٣٣١٢٠٣ :‫هاتف‬
Phone: 013-8331203 ٠١٣-٨٣٢٤٠٦٨ :‫فاكس‬
Fax: : 013-8324068 ٢٠٥٠٢٠٧٥١٣ :‫السجل التجاري‬
C.R.No.: 2050207513

www.adv-met.com

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