Prism Medical UK A-205, Руководство пользователя

Страница: 28 / 32

Page: 28 Rev: 04.2014 A ‐ 205 ‐ Owner’s Manual
Service Record History
Complete this section after each service, repair inspection and/
or maintenance. Photocopy additional pages as required.
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________
Service Type:
□ Periodic Inspection □ Monthly Inspection □ 6 Month Inspection □ Repair □ Yearly Inspection □ Other:_________
Completed By
:
_________________________
_____________________________
Printed Name Signature
Company:
_____________________________________________________________
Remarks & Action Taken:
Date:
_______________________
Time:
________________________