25
GF: Jürgen Scherrieble
Steuernummer 24/140/60001
VAt-No. DE 232257366
HRB 9186
Deutsche Bank Regensburg
BLZ 750 700 24
Kto.Nr. 32 92 935
SWIFT: DEUTDEDB750
IBAN: DE94750700240329293500
Measurement of motor running time:
Motor
Reference value
Actual value
Comments
Height adjustment
Seat
Back rest
Leg rest
Electrical security measurements
Measuring instrument used
Mode
Comments
Surgical chair/model
Serial number
Functional location
Inspection passed. This surgical chair is in compliance with the safety and security requirements.
Marginal deficiencies. This surgical chair should be used under supervision.
Serious deficiencies. The surgical chair must be phased out.
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Date, signature
Infix printout here
