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Sample Form: درخواست مرجوعی کالا

شماره‌ی سفارش، دلیل مرجوعی، عکس کالا و روش بازپرداخت؛ با کد رهگیری برای پیگیری.

9 questions · Free up to 50 responses a month

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About this template

“درخواست مرجوعی کالا” has 9 questions on 2 pages; 6 are required and 3 optional. Question types: Short text (2), Single choice (2), Mobile number (1), Date (1), Long text (1), File upload (1), Card number (1). Its sections, in order: «کالا», «بازپرداخت». 6 ready-made options across 2 choice questions, all editable in the online version.

In the online version of this template

  • Mobile numbers are validated against the Iranian number format.
  • Dates are picked and stored on the Jalali (Persian) calendar.
  • Attached files are stored with the response.
Related:Online form builder

کالا

  1. 1.

    نام و نام خانوادگی *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    شماره سفارش *

    (Short text)
  4. 4.

    تاریخ خرید *

    (Date)
  5. 5.

    دلیل مرجوعی *

    (Single choice)
    • معیوب است
    • اشتباه ارسال شده
    • اندازه/رنگ نامناسب
    • سایر
  6. 6.

    توضیح دلیل

    (Long text)
  7. 7.

    عکس کالا

    (File upload)

    حداکثر ۳ عکس

بازپرداخت

  1. 8.

    روش بازپرداخت *

    (Single choice)
    • کارت بانکی
    • اعتبار خرید بعدی
  2. 9.

    شماره کارت

    (Card number)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
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Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “درخواست مرجوعی کالا”.
  3. Change the questions as you like, publish the form and send the link.

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