You are on page 1of 3

Name of the Instrument-- Range : Identification No---

Acceptance Criteria – Calibration Frequency –

Year of Purchase – Issued to -

Sr Calibration date Next Calibration due Certificate no Actual Error and


No date Acceptance Status
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair
Actual Error :
Accepted
Not Accepted/ Repair

INSTRUMENT FITNESS VERIFICATION DETAILS

1ST Quarter 2ND Quarter 3RD Quarter 4TH Quarter


Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date

Rev. No. Revision details W.E.F


01 Fitness verification details added 15.09.17
1ST Quarter 2ND Quarter 3RD Quarter 4TH Quarter
Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date

1ST Quarter 2ND Quarter 3RD Quarter 4TH Quarter


Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date
ST ND RD
1 Quarter 2 Quarter 3 Quarter 4TH Quarter
Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date
ST ND RD
1 Quarter 2 Quarter 3 Quarter 4TH Quarter
Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date
ST ND RD
1 Quarter 2 Quarter 3 Quarter 4TH Quarter
Year No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date
ST ND RD
Year 1 Quarter 2 Quarter 3 Quarter 4TH Quarter
No Dent No Dent No Dent No Dent
No Damages No Damages No Damages No Damages
No Re Calibration No Re Calibration No Re Calibration No Re Calibration
No Repair No Repair No Repair No Repair

Rev. No. Revision details W.E.F


01 Fitness verification details added 15.09.17
No Misuse No Misuse No Misuse No Misuse
Calibration sticker Calibration sticker Calibration sticker Calibration sticker
Identification marks Identification marks Identification marks Identification marks
Date Date Date Date

Rev. No. Revision details W.E.F


01 Fitness verification details added 15.09.17

You might also like