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Device Installation Report (Service) : Name of Hospital or Clinic

This device installation report documents the installation of a medical device at a hospital or clinic. It records the customer information including name, address, department, bed count and type of facility. It also documents the product details, installation details, checklists for completion and sign-offs from the technician, user, and distributor with dates.

Uploaded by

Vasyl Nastalenko
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1K views

Device Installation Report (Service) : Name of Hospital or Clinic

This device installation report documents the installation of a medical device at a hospital or clinic. It records the customer information including name, address, department, bed count and type of facility. It also documents the product details, installation details, checklists for completion and sign-offs from the technician, user, and distributor with dates.

Uploaded by

Vasyl Nastalenko
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Device Installation Report (Service)

Customer Info.

Name Name of Hospital or Clinic Department

Address
Outpatient
Total Beds Hospital type: Public Private
number per year
Product Decive Model Serial number
Date of
Contact Person Tele / Email
Installation
Installation of Product Completed Yes No Remark
Check list
User Training of Product Completed Yes No Remark

Signature of technician:

Customer comments

Signature of User : Date:


Signature of Distributor : Date:

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