9
Maintenance and Service Plan z50
Customer:
Patient change
[ ] Yes
[ ] No
Year of constr.:
Serial no.:
Wheelchair/z50 general condition:
Driving report:
Application ranges:
Check carefully all parts listed here for correct function, adjustment, damages or deformations and whether
the screw connections are tightened!
OK
Damages
Replacement
Control panel
Control panel holder
Central plug
2 Battery pack
Battery bag
Cables
3 Motors
Adapter plate
Lock
4 Tires
Spokes
Push rings
5 Anti-tippers
6 Options
Notes:
Maintenance performed by:
Place / date:
Signature:
6 Maintenance Plan
Содержание z50
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