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Ventilator

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POOVARASAN K 18BM030
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7 views

Ventilator

Uploaded by

POOVARASAN K 18BM030
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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E-mail: service@amssolutionsinc.

com
PREVENTIVE MAINTENANCE REPORT
Customer Details: Date Visit No Report No
Equipment Make & Model:
Ventilator
Serial Number Department

Mail ID: Contract period Equipment Condition


Mobile No: [ ] Working [ ] Not Working

Equipment Status
Working on AC Voltage [ ] Yes [ ] No Equipment Input Voltage [ ] 220V [ ]110V

Working on Battery [ ] Yes [ ] No Main Supply Voltage L-N: N-E: L-E:


Display Condition [ ] Good [ ] Bad If S/D transformer present, Voltage L-N: N-E: L-E:
If touch display, Working Condition [ ] Good [ ] Bad Filter Cleaning [ ] Yes [ ]No

Pneumatic external damage [ ]Yes [ ] No Pneumatic internal damage [ ]Yes [ ] No

Self Test/ EST [ ] Pass [ ] Fail Oxygen Sensor [ ] Present [ ] Not

If fail, Test Name: Calibration Status [ ] Pass [ ] Fail

Flow Sensors Calibration [ ] Pass [ ]Fail Fio2, Set value: Delivered:


Air pressure: O2 Pressure: Breathing Circuits used with filters [ ] not[ ]
Wheel Condition [ ] Good [ ] Bad

Keypad [ ] Working [ ] Not [ ] Partially

Parameters:

Engineers Comments

Overall Working Condition


[ ]Excellent [ ]Good [ ]Normal [ ]Bad [ ]Don't Use
Customer Comments:

Customer Signature with seal


Customer Name: Engineer's Signature

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