Check List Film Viewer: A. Bahan Pemeliharaan

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Check List Film Viewer

Merk Film Viewer Ruangan

Type No. Inventaris

S/N

A. Bahan Pemeliharaan
No Descriptions Results Quantity

1. Contact Cleaner Pass Fail NA pc

2. tool set Pass Fail NA pc

3. Lap Pass Fail NA pc

4. Multi meter Pass Fail NA pc

B. Main Unit
No Descriptions Results

1. Lampu Pass Fail NA

2. tombol / Switches Pass Fail NA


3. Fittings/Connectors Pass Fail NA

4. Labeling Pass Fail NA

Date Customer Checked By,


Start Time
End Time

( ) ( )

PT.GMM - T/R Div


Formulir Pemeliharaan Alat Kesehatan

A. Pelanggan

Nama Pelanggan
Alamat
Telp/Fax
Contact Person

B. Data Peralatan

Nama Alat Film Viewer


Merk Lokal
Type
S/N

C. Pelaksanaan

Tanggal
UPF/Ruangan
Teknisi

Catatan

Pelanggan Teknisi

( ) ( )

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