HD11 PM 12.4.17
HD11 PM 12.4.17
Customer Details
Address: Contact Information:
DR. PABLO O. TORRE MEMORIAL HOSPITA Michael Eraldo
B.S. AQUINO DRIVE
BACOLOD CITY 08 PH
6100
Order Details
Service Order: 46376440 Operation: 0010 Order Type: ZPM1
Call Type: PM Preventative Maintenance Request Date: 12/04/2017
Engineer: Jessie Perito Priority: 5- Scheduled Activity
Purchase Order: Contract: 42037783
Reported Problem: PM for DEC 2017 (Jul-Dec)
Equipment Details
Equipment: 33223425 Serial: US70530689
Description: HD11 Ultrasound System Affected Equipment: 33223425
Measurement Point: N/A Description: HD11 Ultrasound System
Notes
12/27/2017 7:59:29 PM Jessie Perito(63000013)
1) Was the planned maintenance (PM) performed in accordance with schedule? : Yes
5) Calibrated testers/tools used?:TC187-05 S/N: 3869043 Elec. Safety Tester Fluke ESA620 09-MAY-2018
(If yes, state the name, S/N, Calibration due date: DDMMMYYYY)
Labor Details
Signatures
Philips Representative: Customer/Client: