Sample Receipt Acknowledgement Program Code(Required) Lab Code Allotted(Required) Lab Code is allotted in Hard Copy in PT Item Box Use Lab code in all future correspondences. Date of sample receipt(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Sample Receipt Form Please fill out this form within two days of receiving the sample. If not received within this timeframe, it will be assumed that the sample is intact, and no complaints will be entertained later. For any concerns, report immediately via email. pt@envirocare.co.in The package and PT item/sample(s) inside are found in intact condition & fit for analysis(Required) Yes No Tick as appropriateIf NO, are the samples damaged beyond use? Yes No NA If yes, describe the damage and email the photographic evidence: any concern related to package or PT items are to be raise via email pt@envirocare.co.inRemarks if any:Name of Participating Laboratory/ Organization:(Required) Contact Person Name & Designation:(Required) Email(Required) Mobile No.(Required) Correspondence Information All correspondence should be done by the key person/contact person as per the registration form. For any clarification, email us at pt@envirocare.co.in.
