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Appendix
A
Planned maintenance check form, S/5 Anesthesia and S/5 Critical Care Monitor
A1(4)
Document no. M1125633-06
APPENDIX A: Planned maintenance check form,
S/5 Anesthesia and S/5 Critical Care Monitor
OK = Test OK
N.A. = Test not applicable
Fail = Test failed
Customer
Service
Service engineer
Date
Measuring equipment / test gases used:
Equipment / tool / gas:
Manufacturer:
Model/Type/Part
Number:
Serial Number /
ID:
Calibration
Date:
Monitor Installation
F-CU
F-
K-
D-
S-
L-
E
B-
N-
E
B-
Visual Inspection
OK
N.A.
Fail
2.1.2. Extension Frame, F-EXT4
S/N
2.1.3. Compact Airway Module, E-CXX
S/N
2.1.4. Single-width Airway Module, E-miniC
S/N
S/N
2.1.6. Modules with NIBP measurement
Notes
Summary of Contents for Datex-Ohmeda S/5
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Page 428: ...Datex Ohmeda S 5 Anesthesia and Critical Care Monitors 6 Document no M1137274 01 ...
Page 431: ...Spare parts 9 Document no M1137274 01 3 2 Central Processor Unit for F CU5 F CPU 02 ...
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