Sample Problem Report
Form
<System/Product
Name>
<System/Product
Version>
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Date Reported: |
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Problem ID: |
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Test Phase: |
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Test Case ID: |
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Screen / Process: |
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Cause/Classification: |
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Test Region: |
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Severity Level |
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Reported By: |
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Priority Level |
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Conditions when problem occurred: |
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Brief Description of Problem: (Attach screen prints, if applicable) |
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Assigned To: |
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Assigned Date: |
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Suggested Workaround: |
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Problem Resolution: |
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Fix Date: |
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Retest Date: |
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Promotion Date: |
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Retested By: |
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Technical Approver: |
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Pass / Fail: |
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Functional Approver: |
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Closure Date: |
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