3-13 
 
3.2.5 Preventative maintenance test report 
Customer name   
Customer address   
Servicing person   
Servicing company   
Equipment under test 
(EUT) 
 
Model of EUT   
SN of EUT   
Hardware version   
Software version   
Test equipment  Model/No.  Effective date of calibration 
   
   
   
   
   
   
 
Test items  Test records  Test 
results(Yes/No)
Visual inspection 
The case, display screen, buttons, knob, SMR, modules, power 
cord, wall-mount bracket and accessories have no obvious signs 
of damage. 
 
Ye s   No 
The external connecting cables are not frayed and the connector 
pins are not loose and bent. 
 
Ye s   No 
The external connectors are not loose or their pins are not bent.   
Ye s   No 
The safety labels and data plate are clearly legible.   
Ye s   No 
NIBP test 
The difference is within ±3 mm when 0, 50 or 200 mmHg is set 
for NIBP accuracy test. 
 
Ye s   No 
There is no leakage with NIBP, or the manual leakage test result 
does not exceed 6mmHg/min. 
 
Ye s   No 
Sidestream CO
2
 test