FIELD SERVICE REPORT

BECKMAN
COULTER. 23090
Beckman Coulter India Pvt. Ltd. No. Date: oio2)a02)
CUSTOMER NAME MODEL: FC SO0
AMRI Hrsotas imite SERIAL NO: RA Z270091
WARRANTY: ACTIVE OWNED OTL INSTANCE NO: 28420744
SERVICE REQUESTNO.(S.R NO.) 0-02909656
TASK NO: TYPE OF CALL
DATE TIME
DEPARTMENT: lwutme1
CONTACT PERSON: D. Poomar Gué+ COMPLAINT RECD 0102 9:00 INSTALLATION
RESPONSE 0102 14.co DE-INSTALLATION
ADDRESS:
230, Bomnauhota. dame COMPLETION 012|IS PM VISIT
HRS MINS BREAKDOWN
Munurdapuo. MODIFICATION
CITY/POSTAL CODE: Ko als7000929 LABOUR HRS
TRAVEL HRS APPLICATION
STATE/ COUNTRY Weot BonAol:_
| MOB.TEL. No. 8240 7 80/4 TOTAL HRS
E-MAIL
PROBLEM REPORTED/ SYMPTOM : Evem Cmt Vey luo

OBSERVATIONS/ CAUSE The sapu b e is P a l b lru

ACTION TAKENI RESOLUTION: Rom Cluanse pome e s lomiteDRom

|VERIFICATION OFREPAIR Rom a

pmr
VERIFICATIONGdATEMENT: () TH COREECT OPTION
Service activity performed is verifed to metthespecifiedrequirementsasperestablished procedures.Results meet published
performance specifications.

Verifiled as per establishedprocedures. DocumentedVerificationin ServiceReportDebrief Notes.

FOLLOWING PARTS HAVE BEEN REPLACED FROM-BECKMAN COULTER ORCUSTOMERSTOCKL

PART No. DESCRIPTION UNIT PRICE QTY TOTAL NS
Sr. No.
1
NA

(Taxes Extra) TOTAL Rs.

ADDITIONAL COMMENTS:

IF YES CF TYPE
CF RAISED Y/N
-

We approve the above charges

I certify that the above work has been carried out to my satisfaction.
osamemannda hokydy HOSP
Ruealy
ENGINEERS NAME & SIGNURE oto CHECKED BYS CUSTOMER SIGNATURE

KOLKNIA
Head Office: Unit Nos.TF-B-07(A) to 15 Third Floor, Wing B, Art Guid House, Phoenix Marketcity, LES Road, Kurla (West), Mumbai- 400 070
Telephone: 6838 5000, Fax: 6838 506OIG