Material Disposal Note




Company Name
Quality Assurance Department

Material Disposal  Note


Issue Date: -   

 Revision No: -   


Note No.: _____________________
Date: ________________________
Area / Department:                       ____________________________
Name of R.M. / P.M. / Product:   ____________________________
Code of R.M. / P.M. / Product:    ____________________________
Lot No. / Batch No.:   ____________________________
G.R.N. / T.T. No.: _____________________Date:_________________
Quantity: ____________________________Unit: _________________
Manufacturing Date____________________Expiry Date: ___________
NCR Number: _______________________NCR   Date: ____________

Reason for Destruction: _____________________________________________
________________________________________________________________
________________________________________________________________
Mode of Destruction: _______________________________________________
Area Incharge: ____________________________Date: ____________________

Remarks: _________________________________________________________
_________________________________________________________________

Verified by Department Head: _______________________Date: _____________________
Approved by Q.C. Manager:  _______________________  Date: _____________________
Authorized by Plant Manager: _______________________ Date: ____________________
Destroyed by:                         _______________________  Date: ____________________
Witnessed by Q.A. Officer:    _______________________  Date: ____________________
For Accounts use:

Rate:                _______________________  Value: _______________________

Posted by:       _______________________  Date: ________________________


-tab-count: 1'>      _______________________  Date: ________________________


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