GE Datex-Ohmeda S/5 - Appendix A: Functional Check Form, Datex-Ohmeda S;5 AM, CCM

Appendix A Functional check form, Datex-Ohmeda S/5 AM, CCM
A1(4)
Document no. M1137263-04
APPENDIX A: Functional check form,
Datex-Ohmeda S/5 AM, CCM
OK = Test OK N.A. = Test not applicable Fail = Test failed
Customer
Service
Service engineer
Date
Measuring equipment / test gases used:
Equipment / tool / gas: Manufacturer: Model/Type/Part
Number:
Serial Number /
ID:
Calibration
Date:
Monitor Installation
F-CU5(P) B- N-
F-CPU B-
N-AC B-
F-CU8 B-
L- K-
D- D-
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(s) S/N
5.3.3. Keyboard(s) S/N