BREAS MEDICAL Doc. No. 003259 En Issue: X-1
PV 101+/PV 102+
Information from BREAS
Date received by BREAS:...................... Signature ...................................................
Repair Warranty Update Charge Other
Action taken:
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Parts used: Pcs: Price:
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Operating hours from BREAS:_____________h
Date returned to customer: ________________ Signature:____________________
Notes:
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