GE H
EALTHCARE
D
IRECTION
5213326-100, R
EVISION
3
LOGIQ™ A3 S
ERVICE
M
ANUAL
Chapter 10
10-25
ULTRASOUND INSPECTION CERTIFICATE
* Scan Format: Phased Array, Linear Array, Curved Array, Mechanical Array or Other
FUNCTIONAL CHECKS
PHYSICAL INSPECTION AND CLEANING
COMMENTS:
______________________________________________________________________________
______________________________________________________________________________
Customer Name:
System ID:
Dispatch Number / Date Performed:
Warranty/Contract/HBS
System Type
Model Number:
Serial Number:
Manufacture Date:
Probe 1:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 2:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 3:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 4:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 5:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 6:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 7:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 8:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Probe 9:
Frequency:
Scan Format*:
Model Number:
Serial Number:
Functional Check (if applicable)
OK? or
N/A
Physical Inspection and Cleaning
(if applicable)
Inspect
Clean
B-Mode Function
Console
Monitor
Air Filter
M-Mode Function
Probe Holders
External I/O
Wheels, Brakes & Swivel Locks
Control Panel
Cables and Connectors
Monitor
GE Approved Peripherals (VCR, CD-RW, Printers)
Measurement Accuracy
GE Approved Peripherals
State: RELEASE - Document is released and under formal Change Control. Changes are subject to the ECR/ECO Process.
See the GEHC Myworkshop System to determine the status of this document.
Approved Document - 5213326-100TPH_r3.pdf Page 248 of 252
