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Electrical safety / reports
Device leakage current / report
System:
Material number:
Serial number:
Customer-spec. ident number
Device leakage current
(highest
measured value)
[mA]
Line voltage
during the measurement
[V~]
Device leakage current
(corrected value)
[mA]
(*1) Meas. circuit:
Meas. inst.
type:
Meas. inst.
Ser. No.:
Meas. inst.
calibrated up to:
Assessment:
Date:
Name:
Signature:
(*1) Meas. circuit: See Fig. 2 to Fig. 3, next page
Siemens AG
Medical Solutions
Device leakage current
First measured
value
Repeat measurements value
RXB8-115.034.02
Rev. 03
04.05
Page 3 of 6
CS PS 24
7 - 3
7
POLYMOBIL III
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