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EQUIPMENT REPORT

LOCATION DETAILS
DEPARTMENT: Tel. No/s:
PHILHEALTH 4004

Contact Person:
MARY JANE L. BINARAO

PRODUCT INFORMATION
BRAND: MODEL: SERIAL NO: TYPE:
EPSON EPSON L360 VGFK372210 PRINTER

EQUIPMENTS STATUS
 ALWAYS PAPER JAMMED PRINTOUT NOT OK

FINDINGS

 DEFECTIVE PRINTER HEAD AND ROLLER

ACTION TAKEN
 PULLOUT

REMARKS / RECOMMENDATION
 FOR REPLACEMENT (BROTHER DCP-L2540DW)

ACKNOWLEDGEMENT

ROSLER T. MAGGAY 07/29/2022


______________________ _________________________ ________________________
AUTHORIZED REPRESENTATIVE M.I.S DATE SIGNED
(END USER)

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