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ON-SITE SERVICE REQUEST
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First Name
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Last Name
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Company Name
Email Address
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Phone Number
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Mobile Number
Best Time to Call
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10am to 12pm
12pm to 1pm
1pm to 3pm
3pm to 5pm
5pm to 7pm
7pm to 8pm
Saturday
Sunday
Address
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Please Describe the Problem You Encountered
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Which Part of Your Computer Encountered the Problem
*
CPU
Laptop
Server
LCD Monitor
CRT Monitor
Laserjet Printer
Inkjet Printer
Dot Matrix Printer
All in One Printer
Plotter
UPS or Power Supply
Speaker or Microphone
Network Devices
Optical Drive
Storage Devices
Webcam
Scanner
Other
What Operating System You are Using
*
Windows 95
Windows 98 or 98se
Windows ME
Windows NT
Windows 2000
Windows XP
Windows Vista
DOS
Redhat Linux
Fedora Linux
Mandriva or Mandrake
Ubuntu Linux
Other Linux
Unix
FreeBSD
Mac OS
What Antivirus You are Using
*
Antivir
Avast
AVG
Kaspersky
Mc Afee
NOD32
Norton
PC Cilin
Other Antivirus
None
Any Customized Program Installed in Your System
*
Yes
No
Please add any details or comments that will help us to understand the problem
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