SECTION
C
37
FI
EL
D
I
N
S
P
E
C
T
IO
N
R
EP
O
R
T
A
ss
u
re
® P
lat
in
u
m
B
lo
o
d
G
luc
os
e Mo
n
it
o
ri
n
g
S
ys
te
m
:
Facility:
_________________________________
Date:
___________________________
Contact:
_________________________________________
Address:
________________________________
Time:
__________________________
Phone:
__________________________________________
_________________________________
ARKRAY Representative Signature:
____________________________________________________
N
am
e o
f f
ac
ili
ty
:
S
ta
tion
M
et
er S
er
ia
l #
N
or
m
al
(
L
ev
el
1
) C
ont
ro
l
S
o
lu
tion
Hig
h
(
L
ev
el
2
) C
ont
ro
l S
o
lu
tion
B
at
te
rie
s
S
et t
o C
o
rr
ec
t
S
et
ti
n
gs
M
et
er
Rep
lac
ed
(Y/
N
)
C
om
m
ent
s
Ra
n
ge
R
esul
t
Ra
n
ge
R
esul
t
OK
Ch
ang
ed