Mr/Ms: Mr. Ms.

Name *:

Company Name :

Tel No *:

Email *:

Type of Complaint:
Operating System/Application Related Hardware Problems / Faulty Parts Internet / Email Problems Routing/Network Problems UPS/Battery Problems DC Charger/ DC bank Problems Others

Complaint Coverage::
UPS/DC Charger/Battery Annual Maintenance IT Annual Maintenance Warranty Cover Rental No Applicable Cover

Equipment Details :

Brief Description: :

Device Serial Number

Delivery Note/ Invoice Number

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