GE LOGIQ 200, Quality Assurance Manual, Page: 11 / 196

2277615-100
REV 0
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GE Medical Systems 1/16
Purpose:
Quality Assurance Testing
Customer Name:
Address: System Model:
System Serial #:
System ID #:
Year of Mfg.:
System Status: Warranty Contract Billable
Dispatch #:
Purchase Order #:
System Configuration
Video Cassette Recorder
Line Printer
Video Page Printer
Urological Therapy Guidance
Other ___________________________________
_________________________________________
Field Service Engineer: ____________________________________ Employee #: _______________
TEST EQUIPMENT
NAME MANUFACTURER MODEL Atten. SERIAL # CAL DATE
Leakage Tester
Multimeter
Gray Scale Phantom
Survey Date:
Refer to the Ultrasound QA Reference
Manual 2262684-100 for details.
TRANSDUCERS TESTED
The two transducers used most frequently should be listed as transducer number 1 and 2. Use the
separate documents provided to document the remaining transducers.
Transducer 1
Model: ________________________
Serial Number: ______________________________
Type: General Purpose Superficial Intraoperative
Endorectal Endovaginal Other _____________________
Freq: 2-3.5 MHz 3-5 MHz 5-7.5 MHz 7.5 MHz and higher
Scan Format: Phased Array Linear Array Curved Linear Array
Mechanical Other _____________________
Transducer 2
Model: ________________________
Serial Number: ______________________________
Type: General Purpose Superficial Intraoperative
Endorectal Endovaginal Other _____________________
Freq: 2-3.5 MHz 3-5 MHz 5-7.5 MHz 7.5 MHz and higher
Scan Format: Phased Array Linear Array Curved Linear Array
Mechanical Other _____________________
Configuration Notes:
US Unit Manufacturer:
Biopsy Guide
Spectral Doppler
Color
Samsung GE Medical Systems
LOGIQ a200