BECKMAN FIELD SERVICE REPORT

COULTER.
Beckman Coulter India Pvt. Ltd. No.: 23087
CUSTOMER NAME:_ NRS Medical MODEL: NaviosL
Date: 2csl2_
Colge SERIAL NO: AVO5002
WARRANTY: ACTIVE OWNED OTL
| INSTANCE NO:
SERVICE REQUEST NO. (S.R NO.) W0-o191248
| TASK N0:
DEPARTMENT Plowutonatri1 DATE TIME TYPE OF CALL
CONTACT PERSON:
COMPLAINT RECD INSTALLATION
ADDRESSS:
Lth F l , Dept RESPONSE 250 10o DE-INSTALLATION
taamtoloqy COMPLETION 25/0 110PM VISIT
HRS MINS BREAKDOWNN
CITY/POSTAL CODE: Krtualz LABOUR HRS MODIFICATION
STATE/ COUNTRY:
WeA Beql TRAVEL HRS APPLICATION
MOB.TEL. No.:
TOTAL HRS
E-MAIL:
PROBLEM REPORTED/SYMPTOM: MOD -THpe-3 Foam Vavar o p wdli
OBSERVATIONS/ CAUSE NA

|ACTION TAKEN/RESOLUTION: Pestrrmd_MoD Syslem -

VERIFICATION OF REPAIR: Rer Rc 0c pASGn swLeohuda_

VERIFICATION STATEMENT: () THE COREECT OPTION

TService activity performedisverifedtomeetthe specified requirementsas perestablishedprocedures.Results meetpubished
performance specifications.
Debrief Notes.
LVerified as per established procedures. Documented Verificationin Service Report
PARTS HAVE BEEN REPLACED FROM-BECKMAN COULTER OR CUSTOMER STOCK L
FOLLOWING
TOTAL NS
PART No. DESCRIPTION UNIT PRICE QTY
Sr. No.
2

(Taxes Extra) TOTAL Rs.

ADDITIONAL COMMENTS:

CF RAISED Y/N IF YES CF TYPE

the above charges.
W e approve carried out to my satisfaction.
been
above work has
I certify that the

Borahonbr Coynobbt MormdiOneu

CHECKED BY cuSTOMER SIGNATURE
ENGINEERS NAME & SIGNTURE
PhoenlxMarket clty, LBS
Road, Kurla (Weet Mambak400 070
Unit Nos.TF-B-07(A)
to 15 Third Art Gulld House,
Floor, Wing B, 6838
Head Office: Telephone: 5000, Fax: 6838 5060/61