GE Datex-Ohmeda S/5 Series Technical Reference Manual page 77

APPENDIX A: Functional check form,
Datex-Ohmeda S/5 CAM, CCCM
Customer
Service
Service engineer
Monitor Installation
Frame: F-CM________
Software:
K-
K-
Measuring equipment / test gases used:
Equipment / tool / gas:
OK = Test OK
Visual Inspection
1. Check all units visually
Functional Inspection
5.3.1. General
5.3.2. Display
5.3.3. Keyboard(s)
5. Functional check
5.3.5. Display unit
Appendix A, Functional check form, Datex-Ohmeda S/5 CAM, CCCM
System options:
N-
N-
N-
Manufacturer:
N.A. = Test not applicable
E/M-
E/M-
E/M-
E/M-
Model/Type/Part Serial Number /
Number: ID:
Fail = Test failed
S/N
S/N
Date
Calibration
Date:
OK N.A. Fail
OK N.A. Fail
A
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Document no. M1144951-004