P
AGE
51
1054417, V
ER
. 01
Alice
®
PDx
TM
Service & Technical Reference Manual
T
ESTING
D
ATA
S
HEET
Device Model Number: ______________________
Device Serial Number: ______________________
RA Number (if applicable): ___________________
Test
Step #
Pass
Fail
Completed
Physical Inspection
1
N/A
Install New Batteries
2
N/A
N/A
SD Card
3
N/A
Turn ON - No Errors
4
N/A
Sleepware Installation
5
N/A
N/A
Communications
6
N/A
Add Device
7
N/A
Effort Belts
9 & 14
N/A
Nasal Cannula
10 & 15
N/A
Thermistor
10 & 16
N/A
Pulse Oximeter
11 & 17
N/A
ECG
12, 18 & 19
N/A
EXG
13, 20, & 21
N/A
Patient event
22-24
N/A
Erase SD Card
25
N/A
N/A
Tested By (Print / Sign):
/
Date:
/ /
