Documenting Your Yearly Inspection - Sirona ORTHOPHOS XG 5 Maintenance Manual

2 Annual inspection performed by the system owner or other authorized persons
2.12

Documenting your yearly inspection

The undersigned confirms that he/she has checked the unit for the above criteria and that he/she has informed
the competent dealer in case of any defects.
Year Inspection date:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14
Name:
Sirona Dental Systems GmbH
Signature:
59 87 685 D 3352
D 3352.105.01.11.02