Fora GD20 - Attachment 3: Quality Control Records Result

22
FORA GD20 Blood Glucose Monitoring System Quality Control Results Record
Meter #: Month/Year: Results reviewed by: Attachment 3:
Meter
cleaned
(Y/N)
Test
strip
lot #
lot # range result
Test strip
expiration
date
Level 2 ControlLevel 1 Control
Date Time Station/shift Operator
lot # range result
Level 3 Control
Corrective
action
lot # range result
Low (Y1)
Normal (W2) High (B3)