Keithley 177 Instruction Manual page 54

SERVICE FORM
Model No.
Name
Company
Address
City
Serial No.
State
P.O. No. Date
Phone
-Zip
List all control settings and describe problem.
_
~. (Attach additional sheets as necessary.)
Show a block diagram of your measurement system including all instruments connected (whether power
is turned on or not). Also describe signal source.
Where is the measurement being performed? (factory, controlled laboratory, out-of-doors, etc.)--~~~
What power line voltage is used?
Variation?
Frequency?
Ambient Temperature?
OF.
Variation?
OF. Rel. Humidity?
Other?
Any additional information. (If special modifications have been made by the user, please describe below.)
*Be sure to include your name and phone number on this service form