Siemens MOBILETT XP Digital - MOBILETT XP Digital

Siemens AG SPR8-230.814.30.03.02 MOBILETT XP Digital
11.05 CS SD 24
DHHS report 59
Page 59 of 70
Medical Solutions
11-
10DHHS report
MOBILETT XP Digital 0
The original document remains with the unit, and a copy is filed at the local branch office.
Type / Material No. / Serial No.: ...................................................................................
Customer: ............................................. Customer No.:
........................................................
kV accuracy
Check Control point Check value Additional information
❐ 52 kV / 50 mAs ____________ kV Measuring instrument:
_____________
❐ 81 kV / 20 mAs ____________ kV Serial no.: ______________
❐ 133 kV/12.5 mAs ____________ kV Date of calibration:
_______________________
mAs accuracy
❐ 40 kV / 5 mAs ____________ mAs Measuring instrument:
_____________
❐ 81 kV / 2 mAs ____________ mAs Serial no.: ______________
❐ 133 kV/10 mAs ____________ mAs Date of calibration:
_______________________
Reproducibility
❐ Dose measurement Coefficient of variation
C:
Measuring instrument:
_____________
___________________ Serial no.: ______________
Date of calibration:
_______________________
Name: _________________ Date:______________ Signature:________________