Inspection Certificate - Meyra 1.650 iCHAIR MEYLIFE Operating Manual

INSPECTION CERTIFICATE

Electric wheelchair data:
Model:
Delivery note no.:
Serial-no.(SN):
Recommended safety inspection 2nd year
(at least every 12 months)
Stamp of specialist dealer:
Signature:
Place, date:
Next safety inspection in 12 months
Date:
Recommended safety inspection 4th year
(at least every 12 months)
Stamp of specialist dealer:
Signature:
Place, date:
Next safety inspection in 12 months
Date:
Recommended safety inspection 1st year
(at least every 12 months)
Stamp of specialist dealer:
Signature:
Place, date:
Next safety inspection in 12 months
Date:
Recommended safety inspection 3rd year
(at least every 12 months)
Stamp of specialist dealer:
Signature:
Place, date:
Next safety inspection in 12 months
Date:
Recommended safety inspection 5th year
(at least every 12 months)
Stamp of specialist dealer:
Signature:
Place, date:
Next safety inspection in 12 months
Date:
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