Fon a oe eleead SERVICE REPORT Cae am SS 03950 lM CustomerName «FEM SIMPENE Cals Statistics Labor (time) US Hours Address, MM. Mou sheng @ , EARATON , Travel (time) 1 Hours Travel (days) : Nj Days Luv 1 BiNiecdl . Soo TENE TSS arival on site Contact Person (Bo Mannings Date 10 Mag lor Time : OY 30 Phone No. zi D724 25-34 Instrument returned for service ‘System GENE XeryT Date 10 Mae wa Time 1 Serial No. ACS Type of Service* —: C1] Installation Ci Repair 1 otther..... N/A (21 Preventive Maintenance {21 customer visit Customer Reported NA Ee a bo ok es 2 Work Have Been Done : —_ CLEANING _INST@un€ = BAde ve DATABASE a = MAINTENANCE oat gr? eaath Kom wo OP Remark Adnt DaeaT OIGUNAFAN DENGIN BAI Description Quantity Price/ Unit [Medquest's Technical Support Service Printed Name :_ “TOBY Signature fa Date : (0 MAR Wt *) Give a mark (1) in appropriate square juest Jaya Global ‘Menara Salemba 6th Fl Zone 1, JI Salomba Raye No. §- 6A, Jakarta Pusat 10440 - Indonesia ‘Tolp: 16221 3964 2961, Fax: +6221 3193 77368181 43-Puskesmas Simpong-Luwuk-Indonesia 10/03/21 09:23:07 GeneXpert® Dx System Installation Qualification Report This report provides documented evidence of the installation of this GeneXpert® Dx System. System Information GeneXpert® Dx System Java Runtime Environment Pass GX Utils. DLL Pass SQL Database Microsoft SQL Server 11.00.5058 Pass Database ox.db 3.0.7.0 Pass Operating System Windows 7 6.1 Service Pack 1 Pass CIT Plug-in 1 Pass Instrument Information Instrument B Bt 710534 3.3.3 33.5 Pass 82 710544 3.3.3 33.2 Pass BS 711175 333 32.2 Pass Ba 711473 3.3.3 33.0 Pass ‘Shaded Modules = Reporters out of calibration. Available Assays Xpert HBY Viral Load Xpert HCV Viral Load Xpert HIV-1 Qual Xpert HIV-1 Viral Load Xpert HPV 16 18-45, Xpert MTB-RIF Assay G4 Xpert Xpress SARS-CoV-2 In Vitro Diagnostic In Vitro Diagnostic In Vitro Diagnostic In Vitro Diagnostic In Vitro Diagnostic In Vitro Diagnostic In Vitro Diagnostic Ngee ok oe ad GeneXpert® Dx System Version 4.8 Page 1 of 2