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PHlEU CONG TAC SO (No. ):
B l BRAUN (Service Report.)
,, I ,. I u I ,ru ,,,,1I'<' -
Ngll y (Dale) di.blLtloJdiJ J 0
Ten BV (Hospital) : __ _.,f__.,___ .R K . ..J;'.d4,,.,.. .,?}:(,:.-, .. T/g nh;in th6 ng tin (Break Time ): -· - ·-- ··-- · - - -- -· ··----·--··---··
£>!a chi (Address) : __________ . ___ - ------ - ·· __ .. _ .... . ____ T/glan dlfo (Arrival time ) ----- -------·· -----·- ·- --- - ·- -··
I
NgliCII lllm hf (PIC ) · _____ ___ J:.J:. ___/,,:( =-- -- -- - - .. - Tlglan ket thuc (F inish lim e) -- -·----- --- ---- - ------ - - --·
I
Die n lhoi;ti (Tel..) : ___ ____ --·- ---- _____ - - --·- .. ___ ___ . __ ___ __ ·•---·-- - Ph"lln ml m (SWJ -- -------- - ·
Gia h°'t d~ng (WTC) :--·
Kh oa/ Phong (Dept ) : ____ _ f,:f...,:z,:,,, __ _,,,f_M;, ___!a.{'. _. .. Thai glan d i chuy1fo (Travelling lim e): ----· - --- -
Tl!n thl6t bl {Equip. Data) : Loi;il COng tac (Type of Service) \-
____ __ ./Zc."<!'Lrr-5?- :t_ ___ _ __ -~- _ 0 Lap d~t (Installation) 0 Hudng di n su dung (Training) O S{ta 1111 ch6{0nsile repair) I

MA s6 (Art . No) : _?4.o_g _C:<7..L 0 HO trc;, ti,1 BV (Ons ile support) St'.fa chO'a t(I xa(Remote repair)
0 Gldl thltu may (Demo)
So may (SN) : _ _ _S:.CL ltJ.L.:Lf.1./. D Bao trl (Maintenance) D Saa ti,I VP (lnhouse Repair) O Hl> trc;, tU xa (Remote support)

Sc,i c6 do khach hilng bao (Problem Reported By Customer) :

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., -n~--y
, ,M'~ µ 4"r
-...
Tinh tr,ng/ Nguy6n nhin/ each kh Ac pht,1c (Indication/ Reason/ Solution) :

i ________ _______ ____ ___ __f /. u ' ----~ «--

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______ ______________c~-" ---'.Y---...l<-/4. _,t':_ ___ __ dt:::a-.. ~ '' - '
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______________________da:Y .dL:ad -- ~ ~ __ £ , ~ ... .r/4'~ _. ----·-----·--··-··--·- -----------------
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- - --- - -- -- - - --· - -------- -·-- -- ------ -- ------- ---- ·- ·- ------ ... -- - ----- -- - --- -·- ·-- --·- - - --- ------ - - -------- --- -- - - -- ------
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--- - ------------- -- -------- -------- -·-- - ------.-·-·- - -·-·- - --- -- -·-----·-·-···-· - -- -·- --- - -- ---- ---- - - - - ------- - ---- --- ---- ---- t
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--- ------ -- --------- -- -- ---- - --·--- ---·-- -- --- --- -MOM•------ -M•-- ---------- ---•M
- - -- ---- -- - - -- - -•--- --- -- --- --- - - --- ---- -
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- -------------- --------- - - ----- ---- -·- -·- -- ·---------·---------------------- ·------------·-----------------------------
---- -- - - _,_ ___ -- _____ .. --- - ----------· ----- -------- ---- -----------.- ---- ----- -
Y klt n kh 6ch h• ng (Comment / Customer's Opinion) :
Tinh tr,n g (Statas)

D Hoiln tit (Complete) D Theo d61 (Follow up)

D BAo gl6 (Quotation) D Chti pht,1 tung (Awaiting Spa re)

s6' may (SIN) T 6n p ht,1 tung thay th ' (D escription) S L (O ty ) Thu ph i {Char~•)
MS ph1,1 tung (Pan No .)
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To n 1C uato m111'1 ramP1 Nn.lvtOate\
T &n (Engineer ~ namo) Cl'lO ky ~ .'lln t1 1ure )
Sud 1,1ng n OI b¢ (For 1n1ornel Uso)
N Q, y( Da~J
- l..u&n9 1;!0,_phln kj 1MIOl911•• §191WIM•):
ChO "" {SIQnaM•\

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I H-;;-~ Cha ky (Signature)
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B l BR AUN PHIEU CONG TAC S6 (No.):
(Service Report)
1I "''' t, ru 111'. n i,,;) 1

Nglly (Date)
Ten BV (Hospital) : __/2,,~·-····./?_/;. . . fti. ~ . ........ . - --·• Tfg nh~n th0ng tin (Break Time) : - ··· ··-- ··-- .. -- ..

Oja chi (Address) : ---· -- - ······-- -·· -··· ..... .. . __ _...... .... .. . - .... .... .. T/gian dln (Arrival time)
. V- ,
NgU'ol llin h~ (PIC) . ........ .......tr..r. .... _.... L. .. .. .. ........... .. - --- - ····.. T/glan k,1 !hue (Finish lime)
Dl~n tho;il (Tel .) : . . ............... . - •· .. ·--·- ····- - ···.. .. .. .. ...... .. .. . Gia ho,1 dQng (WTC) : .. .... ...... ______ Phln ml!m (SW)- - .. --------·
Khoa/ Phong (Dept. ) : . ........ . .. . 7..f""':h:z. _...J.. .;~~k>.~... ..!(}.( Thal glan di chuyen (Travelling time): ---...... --- -
Ten thlet bi (Equip. Data): Lo,1 C6ng t6c (Type of Service)
_.......... ..P.t.dk;f.. : ....·---~·-- D LAp d6t (Installation) D Hudng din si'J d,,mg (Trainin!l) D Sit'
Ma s6 (Art No) : .. .:1.....1.f..2.t!.f.L.. D Gldl thitu may (Demo) Iii! H6 trq 1,1 BV (Onslte support)
S6 may (SN):___ S..12..i...f.Jl..O.i.i / J Bao trl (Maintenance)

SI/ co do khach hang bao (Problem Reported By Customer) :

Tlnh lr(lng~ fi'fs"j Y klen khllch hing (Comment/ Customer's Opinion) :

llil Hoan tat (Complete) D Theo dol (Follow up)

@I Bao gla (Quotation) D Ch~ phi,r tung (Awaiting Spare)

MS phi,r tung(Part No.) s6mlly (SIN) nn ph1,1 tung thay th~ (Description)
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!bllc hl6n bal (Work carried by) :

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Tlln (Engineer's name) ChO ky (Signature) Ngay(Date)
·Sll di,rng nl)I bl) (For Internal Use)

nn (Name)