Item Checklist

ITEM CHECKLIST ITEM CHECKLIST
Instruction: Kindly mark () if the item is included. Instruction: Kindly mark () if the item is included.
ITEM INCLUDED ITEM

O2 Sensor Dinamap 5 Parameters
ACCESSORIES ACCESSORIES
Power Cord Power Cord
Transformer SPO2 Cable (Dinamap)
Reusable SPO2 Probe
Checked by: Date: Dinamap Printer
ECG Cable 3 Leads
Name & Signature Dinamap BF Cuff Cable
Checked by:
Name & Signature

Instruction: Kindly mark () if the item is included. Instruction: Kindly mark () if the item is inclu
ITEM ITEM
G3G Sensor G3G Analog (6 Parameters) Cardiac Monitor
ACCESSORIES INCLUDED ACCESSORIES

ECG Cable 5 leads ECG Cable 5 leads
SPO2 Cable (Dinamap) SPO2 Cable (Analog)
Reusable SPO2 Probe BP Cuff Cable
BP Cuff Cable Power Cord
Power Cord ECG Printer
ECG Printer ETCO2 Module
Mini Extension Mini Extension
Checked by: Date: Checked by:
Name & Signature Name & Signature

ITEMS INCLUDED ITEM

Syringe Pump HT50
Power Cord Three Prong Power Cord
Support Arm w/ Hanger
Checked by: Date: Hose
Guage
Name & Signature Stand
Humidifier
Checked by:
Name & Signature

ITEMS INCLUDED ITEM

PB7200 HT70
Support Arm w/ Hanger Support Arm w/ Hanger
Three Prong Power Cord Oxygen Blender
Hose Gauge
Humidifier Hose
Gauge Stand
Humimdifier
Checked by: Date:
Checked by:
Name & Signature
Name & Signature

ITEM INCLUDED ITEM

PB840 NMI E100M
Monitor Three Prong Power Cord
Breathing Delivery Unit Support Arm w/ Hanger
Detachable Compressor Stand
Three Prong Power Cord Gauge
Support Arm w/ Hanger Humidifier
Hose Hose
Gauge
AVR Checked by:
Humidifier
Name & Signature
Checked by: Date:
Name & Signature

ction: Kindly mark () if the item is included. Instruction: Kindly mark () if the item is included.
ITEM INCLUDED ITEM

Esprit Bella Vista
Three Pong Power Cord CO2 Sensor
Support Arm w/ Hanger SPO2 Sensor
Hose Hose
Gauge Flow Sensor
Stand Stand
Humidifier Gauge
Three Pong Power Cord
Checked by: Date: Support Arm w/ Hanger
Humidifier
Name & Signature
Checked by:
Name & Signature

ITEM INCLUDED ITEM

Knight Star Trilogy
Three Prong Power Cord Three Prong Power Cord
Support Arm w/ Hanger Stand
Tygoon Tube for Oxygen Flowmeter Detachable Battery
Oxygen Gauge w/ Flow Meter Oxygen Gauge w/ Flow Meter
Stand Tygoon Tube for Oxygen Flowmeter
Humidifier Humidifier
Checked by: Date: Checked by:
Name & Signature Name & Signature

ITEM INCLUDED ITEM

Sechrist IV-100B Babylog 8000
Thre Prong Power Cord Gauge
Gauge Hose
Stand Humidifier
Hose Stand
Humidifier Flow Sensor
Flow Sensor Cable
Checked by: Date: Expiratory Valve
Name & Signature Checked by:
Name & Signature

ITEM INCLUDED ITEM

Infant Star 950 VIP
Three Prong Power Cord Three Prong Power Cord
Gauge Monitor
Stand Stand
Humidifier Gauge
Hose Hose
Flow Sensor
Checked by: Date: Humidifier
Name & Signature Checked by:
Name & Signature

KLIST ITEM CHECKLIST
f the item is included. Instruction: Kindly mark () if the item is included.
INCLUDED ITEM INCLUDED

G3G Analog (7 Parameters) Cardiac Monitor
ACCESSORIES
ECG Cable 5 leads
SPO2 Cable (Analog)
BP Cuff Cable
Power Cord
ECG Printer
ETCO2 Module
Mini Extension
Date: Invasive BP Cord
Checked by: Date:
Name & Signature
M CHECKLIST ITEM CHECKLIST

k () if the item is included. Instruction: Kindly mark () if the item is included.

diac Monitor Pulse Oximeter
ACCESSORIES
Power Cord
SPO2 Cable Digital
Mini Extension
Checked by: Date:
Name & Signature
Date:


Achieva PSO2
ACCESSORIES
Three Prong Power Cord
Hose
Gauge
Stand
Humidifier
Date: Checked by: Date:
Name & Signature


PLV102
ACCESSORIES
Hose
Gauge
Stand
Peep Valve
Humidifier
Date:
Checked by: Date:
Name & Signature


PB760
ACCESSORIES
Hose
Gauge
Humidifier
Checked by: Date:

Date: Name & Signature


Vision
ACCESSORIES
Hose
Gauge
Stand
Checked by: Date:
Name & Signature
Date:


E200
ACCESSORIES
Stand
Gauge
Humidifier
Hose
Date: Checked by: Date:
Name & Signature


Infant Star
ACCESSORIES
Gauge
Stand
Humidifier
Hose
Checked by: Date:


Bearcub
ACCESSORIES
Gauge
Humidifier
Hose
Stand
Checked by: Date:

Item Checklist

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ITEM CHECKLIST ITEM CHECKLIST

ITEM INCLUDED ITEM

Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ACCESSORIES INCLUDED ACCESSORIES

Checked by: Date: Checked by:

Name & Signature Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ITEMS INCLUDED ITEM

Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ITEMS INCLUDED ITEM

ITEM CHECKLIST ITEM CHECKLIST

ITEM INCLUDED ITEM

Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ITEM INCLUDED ITEM

Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ITEM INCLUDED ITEM

Checked by: Date: Checked by:

Name & Signature Name & Signature

ITEM INCLUDED ITEM

Name & Signature Checked by:

Name & Signature

ITEM CHECKLIST ITEM CHECKLIST

ITEM INCLUDED ITEM

Name & Signature Checked by:

Name & Signature

INCLUDED ITEM INCLUDED

Checked by: Date:

Name & Signature

M CHECKLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Checked by: Date:

Name & Signature

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Date: Checked by: Date:

Name & Signature

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Name & Signature

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Checked by: Date:

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Checked by: Date:

Name & Signature

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Date: Checked by: Date:

Name & Signature

INCLUDED ITEM INCLUDED

Checked by: Date:

Date: Name & Signature

KLIST ITEM CHECKLIST

INCLUDED ITEM INCLUDED

Checked by: Date:

Date: Name & Signature

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