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Instructions:

Please review the following information, then make a selection for each of the items below. Once you are done, hit the "Submit and Print" button, then hand the form to the customer.

Ticket info:

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Contact method:

Contact number:

Customer name:

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Due time:

Estimated cost:

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Device model:

Device serial number:

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Technician name:

Store phone number:

Store email:

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Customer remarks:

Pre-repair inspection:

Repairs to be performed:

Submit

CPR Check-in by Ben Wyborney