Delivery report
Leica M220 F12 / Ref. 10 716 922 / Version 03 53
7 Delivery report
Assembly and functional testing of the Leica M220 F12 was carried out properly in accordance with the regulations contained in the
assembly instructions.
Name and address of the customer
Department
Representative of Leica Microsystems (Schweiz) AG, Medical Division
Name
Address
Acknowledged
Signature
Location
Date
This acceptance certificate must be filled out by the responsible installation engineer and a copy given to both the customer and the Leica
Microsystems representative.
Must be retained for: 20 years
