GE Datex-Ohmeda S/5 Series - Page 77

Appendix A, Functional check form, Datex-Ohmeda S/5 CAM, CCCM
A-1(4)
Document no. M1144951-004
APPENDIX A: Functional check form,
Datex-Ohmeda S/5 CAM, CCCM
OK = Test OK N.A. = Test not applicable Fail = Test failed
Customer
Service
Service engineer
Date
Monitor Installation
Frame: F-CM________ System options: E/M-
Software: N- E/M-
K- N- E/M-
K- N- E/M-
Measuring equipment / test gases used:
Equipment / tool / gas: Manufacturer: Model/Type/Part
Number:
Serial Number /
ID:
Calibration
Date:
Visual Inspection OK N.A. Fail
1. Check all units visually
Functional Inspection OK N.A. Fail
5.3.1. General
5.3.2. Display
5.3.3. Keyboard(s) S/N
5. Functional check S/N
5.3.5. Display unit