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    PERMULAB SDN BHD (392059-X) : Form 1

    Uploaded by

    Andrew Tan
    This document is an analysis request form from Permulab SDN Bhd, a laboratory in Petaling Jaya, Malaysia. It requests information about a sample including the company name, report recipient, sample source and description, number of reports needed, and tests or parameters to analyze. Fields are included for the total number of samples, billing instructions, requested completion date, and signatures of the sender and receiver.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PERMULAB SDN BHD (392059-X) : Form 1

    Uploaded by

    Andrew Tan
    57 views2 pages
    This document is an analysis request form from Permulab SDN Bhd, a laboratory in Petaling Jaya, Malaysia. It requests information about a sample including the company name, report recipient, sample source and description, number of reports needed, and tests or parameters to analyze. Fields are included for the total number of samples, billing instructions, requested completion date, and signatures of the sender and receiver.

    Original Description:

    Analysis

    Original Title

    Analysis

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    This document is an analysis request form from Permulab SDN Bhd, a laboratory in Petaling Jaya, Malaysia. It requests information about a sample including the company name, report recipient, sample source and description, number of reports needed, and tests or parameters to analyze. Fields are included for the total number of samples, billing instructions, requested completion date, and signatures of the sender and receiver.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    57 views2 pages

    PERMULAB SDN BHD (392059-X) : Form 1

    Uploaded by

    Andrew Tan
    This document is an analysis request form from Permulab SDN Bhd, a laboratory in Petaling Jaya, Malaysia. It requests information about a sample including the company name, report recipient, sample source and description, number of reports needed, and tests or parameters to analyze. Fields are included for the total number of samples, billing instructions, requested completion date, and signatures of the sender and receiver.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    PERMULAB SDN BHD (392059-X)

    A-G-16, MERCHANT SQUARE@TROPICANA, JALAN TROPICANA SELATAN 1, TEL : 03-7883 0068


    PJU 3, 47410 PETALING JAYA, FAX : 03-7883 0065
    SELANGOR DARUL EHSAN, MALAYSIA EMAIL : info@permulab.com.my
    WEB: www.permulab.com.my

    ANALYSIS REQUEST FORM Master Copy

    PAYMENT: TERMS / PAID / Not PAID / DEPOSIT Form 1.doc


    Pg ( / )
    *Please fill in this form and send together with your sample *Kindly tick √

    Lab. Reg. No : Address :


    *Company Name :
    *Report Attention To :
    *Sample Source : Tel No. :
    *Sample Description : Fax No. :
    *Sampling Date : *Sender Name :
    Receive Date : *H/P No. :
    *No of Report Required : 1 (W) / 2 (F) / ………. copies Turnaround Time : days
    *Report : Separate / Combine Report sent via : Fax
    Email
    Type of Industry: Pulp and Paper Industry T Textile Industry Fermentation and Distillery Industry
    (*For water sp only) Other Industries: Please Specify

    No. *Sample Marking *Test/ Parameter Standard Remark /


    Method ref

    Total number of sample : ………………………


    Note to accounts personnel : Report bill to …………………………………………………. (if applicable)

    Actions to be taken by Information

    Customer request date for completion of analysis: ………………………

    Sender Name & Signature Received By

    …………………………. …………………….
    Name : Name:
    Date : Date :

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