Assessment Form Excel

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CLIENT NAME San Jose District Hospital

ADDRESS San Jose, Occidental Mindoro


EQUIPMENT Carestream K-NUMBER 54830
MODEL Ascend (Xray) SERIAL NUMBER Qrad-17R

ASSESSMENT
Anode volt error and Cathode Volt error when using high factor. Possible problem is the Generator 2 - batte
Exposure hand switch is deffective. Collimator bulb is working, Tube - No arcing in HV cables. Table - all locks is work
Tube stand - alligned and all locks is working. Handgrip assembly - all buttons are intact and working. Wall stand - l
Generator: Suspected battery problem. All boards had voltage present. We can test the full function of the machine
replace with new one and to find if the error will clear or cause by other components.
REMARKS
For quotation of exposure hand switch (1) and 2 Battery trays.
Machine is functional and in use

VITA FLEX
CLIENT NAME San Jose District Hospital

ADDRESS San Jose, Occidental Mindoro

EQUIPMENT Carestream K-NUMBER 58014


SERIAL NUMBER
MODEL Vita Flex 210817

ASSESSMENT

REMARKS

DV5700
CLIENT NAME San Jose District Hospital
ADDRESS San Jose, Occidental Mindoro
EQUIPMENT Carestream K-NUMBER 58016
MODEL DV5700 SERIAL NUMBER 57041

ASSESSMENT
REMARKS
No Parts quotation needed.

SERVICE PROVIDER: John Cristopher Lam CUSTOMER: Mr. Noel De


DATE 31-Mar-22
DEPARTMENT Radiology
54830648
Qrad-17R-09010

e problem is the Generator 2 - battery sets.


n HV cables. Table - all locks is working and alligned.
re intact and working. Wall stand - lock is working.
est the full function of the machine if the battery is
cause by other components.

d 2 Battery trays.
se

DATE 31-Mar-22

DEPARTMENT Radiology

58014812

210817903

DATE 31-Mar-22
DEPARTMENT Radiology
58016521
57041069
Mr. Noel De La Cruz

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