Maintenance Report

Hospital Name :
PIC :
Instrument : Afinion AS100 Analyzer / Afinion 2
SN :
Year :

Routine Maintenance Quality Control

HbA1c / CRP / ACR / Lipid Panel HbA1c / CRP / ACR / Lipid Panel
Cartridge
Exterior
Month Date Chamber QC Lot Number Reference Range Control Result QC Lot Number Reference Range Control Result
Cleaning
Cleaning
L1 L2 L1 L2 L1 L2 L1 L2 L1 L2 L1 L2
January

February

March

April

May

June

July

August

September

October

November

December

Upgrade Software
Date of
software Old Software Latest Software Acknowledge by:
installation

(Customer) (Distributor)