SERVICE REPORT

REPORT NUMBER :
DATE RECEIVED CALL : 11/16/2021
DATE SERVICED : 11/18/2021

MAINTENANCE : CUSTOMER : Diliman Doctors Hospital

FOR CHECK UP/ REPAIR ADDRESS : 251 Commonwealth Ave, Matandang Balara, Quezon City, 1119 Metro Manila
SERVICE CALL EQUIPMENT TYPE : 3 in 1 Ventilator
FOR EVALUATION
INSTALLATION BRAND : IMTMEDICAL HOUR READING :
RECALL - UPGRADE MODEL : BELLAVISTA INVENTORY NO : 1
SERIAL NUMBER : MB105723 DEPARTMENT : PULMONARY

REPORTED PROBLEM :
WARRANTY : Faulty Touchscreen
YES Battery Faulty Error 324
NO ASSESMENT AND INITIAL FINDING :
CONTRACT Untouchable touchscreen
1 Battery pack Deflated due to overuse
WORK DONE :
Replace Touchscreen and LCD Display Run In both AC/Battery source
FOR BILLING : Replacement of Battery Pack Testing Actual Voltage/Current of Battery packs
YES Calibration of Oxygen Sensor - Passed Replacement of Water trap
NO Self Test Passed, Insp Valve passed Pressure Drift Calibration
Circuit Leak test Passed, Calibration of Flow Sensor
Actual/Simulation of Ventilation - Settings of Tidal Volume, Peep, Oxygen Percentage, PRV, PLV
Clean and Functionality Test, Power On button, Indicator Light Display, Charging Indicator
PARTS AND CONSUMMABLES USED:
Touchscreen and LCD Display
Battery Pack - 14.4 maximum Voltage
Water Trap

REMARKS- RECCOMENDATION
READY FOR PATIENT USE
FOP OBSERVATION
FOR REPAIR
FOR PULL OUT

BIOMEDICAL ENGINEER - TECHNICIAN HOSPITAL/CUSTOMER REPRESENTATIVE

SIGNATURE OVER PRINTED NAME / DATE SIGNATURE OVER PRINTED NAME / DATE