Proficiency Testing Program Sample Receipt Form: CIN NO. U74140DL2010PTC201479

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SRF/GPTP/PTB/PPCC/63/2021/00

CIN NO. U74140DL2010PTC201479 Proficiency Testing Program

Sample Receipt Form

Scheme Name: Chemical Properties of Cement (PPC)


Scheme Code: PTB/PPCC/63/2021

Details of Participating Laboratory


Name of the Contact Person
Designation
Name of the laboratory
Address

Telephone/Mobile No.
Fax No.
E-mail Address

In order to help us to monitor the progress of the proficiency testing program, we request each
participating laboratory to fill up this receipt form on receipt of samples and mailit to:
(To be filled in by the participating laboratory)
Date of Receipt

Condition of sample received

Description of non conformance (if


any)
Mode of receiving sample

No. of samples received

Any suggestions

Signature & Date

Name of the Coordinator Mrs. Rimika Mathur


Address Global PT Provider Pvt. Ltd.
F-89/22, Okhla Industrial Area, Phase-I, New Delhi-110020
Telephone No. +91-9873001545, +91-9582999061,PH-+91-11-40722200
E-mail Address [email protected]

Issue No:01 Revision No: --


Issue Date: 28.06.2019 Page 1 of 1 Revision Date: --

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