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28 OM00ELV8 Rev 3 effective 110118
SERVICE PARTS FORM
Champion Manufacturing
2601 Industrial Parkway, Elkhart, IN 46514
Tel.: –800-998-5018
Fax: –574-293-5760
Customer name: _________________________________________
Customer address: ________________________________________
Tel: _________________ Fax: __________________
Ordering spare parts for Serial Number
_______________________
Pieces Art.-Nr.
Description
E8-ARMHAS
Armrest height adjusting stirrup
E8-BATTERY
Battery unit
E8-ELECCBX
Electronic control box without reading lamp connector
E8-PWRCBL
Power cable (Nema 5-15)
E8-FOIL
Foil of the handset
E8-HNDST
Handset
E8-CSTRCB
7,5 cm twin wheel castor for central operating brake system
E8-PDLCBR
Pedal for central brake, right
E8-PDLCBL
Pedal for central brake, left
E8-BKRSTMTR Backrest motor
E8-SEATTMTR Seat tilt motor
E8-LGRSTMTR Leg rest motor
E8-SEATHMTR Seat height motor
E8-ARMMECH Armrest mechanism for easy patient transfer
E8-ARMS
Arms (vinyl only)
E8-PAD
Pad (vinyl only)
E8-PILLOW
Pillow (vinyl only)
E8-ARMSTRP
Arm rest strap for handset (vinyl only)
Date: ____________________
Signature: ________________________