Supplyco-Outlet Feedback Form

Shri. Pinarayi Vijayan
Chief Minister

Launch by

Adv. G.R Anil
Minister for Food and Civil Supplies

on 03-02-2022

Dr. Sanjeeb Patjoshi IPS
Chairman & Managing Director

Please Submit your Feedback here

FEEDBACK SUPPLYCO

Customer Details

Customer Name

Valid.

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Age

Valid.

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Gender

Valid.

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Profession

Valid.

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Bill /Invoice No

Valid.

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Date of Purchase

Valid.

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Email Id Eg:demo@gmail.com

Valid.

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District

Valid.

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Outlet Type

Valid.

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Outlet

Valid.

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Valid.

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Rate Your Outlet

1. Layout of Products on display racks

5 4 3 2 1

2. Lighting illumination inside shop/Outlet

5 4 3 2 1

3. Product Availability

5 4 3 2 1

4. Quality of products

5 4 3 2 1

If poor quality list out atleast 2 products name

Valid.

Please fill out this field as valid format.

5. Cleanliness of toilet(if available)

5 4 3 2 1

6. Behaviour of outlet staff

5 4 3 2 1

7. Location of supplyco store

5 4 3 2 1

8. packing of sabari products

5 4 3 2 1

9. Cleanliness of outlet/shop/market

5 4 3 2 1

10. Overall Grading

5 4 3 2 1

If any remarks

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