| CCRF No | |
| Complaint Received On | |
| Complaint Received Mode |
Customer Details |
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| Name | Address | ||
| Contact No | Email Id | ||
Product Details |
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| Product Type | Product Name | ||
| Batch No | |||
Data Collection |
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| Invoice No | Invoice Date | Quantity Dispatched | |||
| BRCOA No | BRCOA Date | Details of any other Complaints received from this Production Run | |||
Investigation Details |
|||||
| Device Failed To Meet Specification | Labelling Error | ||||
| Error in Instruction For Use(IFU) | Raw Materials / Components | ||||
| Packaging Error | Processing | ||||
| Interim Containment Action | |||||
Root Cause |
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CAPA |
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| Corrective Action | |||||
| Preventive Action | |||||
| Status | |||||