Title Page
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Prepared by
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Location
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Date/Time
Non-conformances/ Complaint Log
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Source
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Nonconformity Description
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Date
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Name
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Observation
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Categories (minor/major/critical)
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Evidence
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Root Cause - 5 Why technique
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Department
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Correction action required
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Estimated Completion Time
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Status
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Closure Verification
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Corrective Action:
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Verified and Validated by:
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Signature