cg';"lr–!

g]kfn ;/sf/

jg tyf e"–;+/If0f dGqfno

jg:klt ljefu

Kf|fs[lts ;Dkbf cg';Gwfgzfnf

kl/If0f cg'/f]w kmf/d (ANALYSIS REQUEST FORM)

!=lsl;d(Commodity) M s= ;'ulGwt t]n(Essential oil) v= 5f]qmf(Marc) u=cGo Click here to enter text.

@=kl/If0f u/fpg] s'/fx? (Requested analysis) s= klxrfg (Identification) v=cGo Click here to enter text.

#= gd'gf ;+sng÷pTkfbg u/LPsf] If]qM ( Place of sample collection) testing

$=;+sng÷pTkfbg u/LPsf] ldlt (Date of collection) testing

%=gd'gfsf] yk hfgsf/L (Sample description):

gfd (Sample name): testing	ef}lts cj:yf (State): t/n cw{t/n 7f];	/ª (Color): testing
uGw (Odor) : testing	plDng] ÷klUng] tfkqmd (BP/MP): testing	gd'gfsf] kl/df0f (Quantity ofSample): Click here to enter text.
ld;fj6 ePdf (Possible impurities): Click here to enter text.	gd'gfsf] efF8f(Sample holder material): Click here to enter text.	ljiffQmtf (Toxicity if any): Click here to enter text.
s}lkmot(Remarks): Click here to enter text.

^= gd'gfsf] ;+Vof(No. of sample/s): Click here to enter text.

s= kl/If0fsf] nflu (For analysis)

v=j}slNks (For Retention)

u= ;]jfu|fxLsf] nflu (For Client)

&= gd'gf ;+sng÷ pTkfbg u/LPsf] ljlw (Method of sample preparation/sample origin description):

Click here to enter text.

*= ljz]if kl/If0f ljlw ePdf (Test Methods If any):

Click here to enter text.

sfof{no k|of]hgsf] nflu dfq (For Official use only): gd'gfsf] gfd (Sample Name): Click here to enter text. ;f=lj=g=;+= (PAS no) Click here to enter text. ldlt ( Date): Click here to enter a date. kl/If0f ug{' kg]{ s'/fx? (Parameter/s To be nalyzed): Click here to enter text. gd'gfal'emlng] (Sample Receiver): Click here to enter text. (= gd'gfsf] nfluckgfpg' kg]{ ;fjwfgLx? (Precaution to be taken while handling the sample (If any):

Document No.: 2070-00-01 ARF(A)

lgj]bs :jo+n] eg]{ (To be filled by Applicant):

lgj]bssf] gfd (Name of applicant): Click here to enter text. ;+:yf (Organization): Click here to enter text.

bhf{ (Designation): Click here to enter text. 7]ufgf( Address): Click here to enter text.

ldlt (Date): Click here to enter a date. ;Dks{ g=+ (Phone no): Click here to enter text.

kl/If0fsf] p2]Zo (Purpose of analysis):
cg';Gwfg ( Research):

Joj;flos (business) (lgof{t ug]{ b]z (exporting country Click here to enter text. )

cGoM Click here to enter text.

ljz]if kl/If0fljlwePdf (Special Test Methods If any): Click here to enter text.

x:tfIf/ ( Signature) …………………………

sfof{no k|of]hgsf] nflu dfq (For Official use only): gd'gfsf] gfd (Sample Name): Click here to enter text.	;f=lj=g=;= (PAS no.) Click here to enter text. ldlt (Date): Click here to enter a date. kl/If0f ug{' kg]{ s'/fx? (Parameter/s To be Analyzed): Click here to enter text. gd'gf al'emlng] (Sample Receiver): Click here to enter text.

Document no:2070-00-01 ARF (B)

;]jfu|fxL k|lt (Customer copy) -s[kof ljZn]if0f k|ltj]bg (Report) lng cfpFbf of] k"hf{ lnP/ cfpg' xf]nf . _ lsl;d(Commodity):Click here to enter text.	gd'gfsf] gfd (Sample name) Click here to enter text. btf{ g+= (Entry) Click here to enter text. gd'gf a'lemlng] (Sample Received by): Click here to enter text. ldlt(Date): Click here to enter a date.

Document no:2070-00-01 ARF (C)

Form to be filled up by Analyst and Reporter

Instrument used for analysis Click here to enter text.

Date of analysis Click here to enter text.

Analyst Click here to enter text.

Method of analysis. Click here to enter text.

Special case if any. Click here to enter text.

Folder/ location in computer. Click here to enter text.

Results Click here to enter text.

Report no Click here to enter text.

Reported by Click here to enter text.

Reporting date Click here to enter text.

Remarks Click here to enter text.

Checked by

Name Click here to enter text. Designation Click here to enter text. Signature Click here to enter text.

!#= kl/If0f k|ltj]bg a'lemlng] (Report received by)

gfd : Click here to enter text. 7]ufgf: Click here to enter text.

kmf]g g Click here to enter text. b:tvt Click here to enter text. ldlt Click here to enter a date.

Feedback -k[i7kf]if0f_:

Click here to enter text.