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Warranty Certificate
For repair (change) within the warranty term
Medical device - « Hearing Aid »
Technical conditions TU 9444-004-81271212-2010
Number and production date________________________
Purchased _____________________________________
(date, signature and stamp of seller)
set in operation __________________________________
(date, signature)
accepted for warranty _____________________________
Reclamations
For a reclamations the following form must be filled in:
Initial
exploitation
date
Problem
occurrenced
date
Brief
description
of problem
Comments
