Siemens SC 7000 Service Manual page 107

SC 7000 and SC 9000XL Patient Monitors
Enter all applicable data in the spaces provided, and include a copy of this form when faxing a
request for technical assistance.
Name of contact
Telephone
Fax
Email Address (If available)
Monitoring Site:
Device Type:
Device Serial Number:
Device Operating Software:
Care Unit Type:
Parameters being monitored at time of fault:
Network / Stand-alone Use
Brief Description of Fault:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Can the problem be reproduced or is the problem intermittent?
Has TSS been previously contacted concerning this problem?
Has a customer complaint on this product been filed?
Complaint Reference Number (If applicable)
Fax inquiry to:
TSS SOLNA
TSS DANVERS
ASK-T898-03-7600
7k9kXLSM.c5.CD_ROM.fm/04-99/kaupp
Problem Report
SC Series Patient Monitoring
Country:
Region / State / Province:
Hospital or Clinical Site:
46-8-98-66-62
978-907-7546
Siemens Medical Systems, EM-PCS Danvers
NOT A CONTROLLED DOCUMENT
Service Manual
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