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Preventive Maintenance Checklist

Equipment : Spirometer Date :


Brand : Period :
Serial No. : Room :

No Physical / Quantitativ Test Pass Fail


1 Periksa body / Kondisi Baterai
2 Kontrol / Switch
3 Perlengkapan / Konektor
4 Kable / Aksesoris
5 Indikator / Display
6 Periksa Display
7 Periksa Filter
8 Periksa Perinter
9 Periksa Kondisi Kabel ECG (6 Bulanan)
10 Periksa fungsi dengan pengaturan standar

Test Equipment Used :

Remarks :

Performed by : Verifled by :

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