Company: [company legal or brand name]
Product or service: [what you bought or used]
Order / account / policy / bill number: [number]
Date of purchase or service: [DD-MM-YYYY]
Amount paid: Rs. [amount]

What went wrong:
[2 to 5 short lines, in date order]

My complaint to the company:
On [date] I complained to the company by [email / app / call / letter], reference no. [____]. [It replied on [date] saying ____. / It has not replied.]

What I want:
[refund of Rs. ____ / replacement / repair / service restored / bill corrected] within [__] days.

Documents I am uploading:
1. Invoice or bill
2. My complaint to the company and its reply
3. [Screenshots, photos, bank statement]

Name: [your name]
Mobile: [registered mobile number]
Email: [registered email]
City and state: [city], [state]