Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 180613012948

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 99 OK
NIBP 200 mmhg ±5 198 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 191007153447

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 98 OK
NIBP 200 mmhg ±5 197 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 170927222629

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 101 OK
NIBP 200 mmhg ±5 199 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 170930084727

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 98 OK
NIBP 200 mmhg ±5 199 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 191004062407

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 102 OK
NIBP 200 mmhg ±5 203 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 190827082218

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 97 OK
NIBP 200 mmhg ±5 199 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
 Sphygmomanometer Installation Checklist

Date: 09/08/2021
Model : DS45
Serial no: 170526061019

Qualitative Tests Result

Physical Condition OK
Zero point OK
Nibp cuffs & tubes OK
Nibp pump OK
Wall mount NA
Labels OK

Parameter test Test value Findings Result

NIBP 100 mmhg ±5 102 OK
NIBP 200 mmhg ±5 201 OK

Test Units Asset

Nibp Analyzer TO-754, Fluke Prosim 4 Sn: 5093048

Hospinorm engineer
Name : Ajmal

Signature:
Hospinorm Maintenance Management, LLC
Techno Hub2, Dubai Silicon Oasis
Tel: +971 4 313 7000 | Fax: +971 4 501 4100
Toll Free: 8004981
A subsidiary of Gulfdrug L.L.C
Email: service@hospinorm.com

Service Report
No : SR-501490-2
Hospital / Medical Center
Name : YAS CLINIC - KHALIFA CITY ABU DHABI Address :
Account Number : IY04 Location / Department : Yas clinic

Work Details

Eng/Tech : Mohammed Ajmal Mohammed Start Time : 9 Aug 2021 18:00 Travel Hours: 00:00
Job Code : INSTALL Installation of equipment End Time : 9 Aug 2021 19:00 Labor Hours: 01:00
LPO# WCODS/PO/2021/07/417 SO#
Error Reported: PM Type : Overtime Hours : 00:00
1309476
Originating Record: 24638

Labor
Name Hours: Start Date: Start Time: End Date: End Time: Type
Mohammed Ajmal Mohammed 01:00 09/08/2021 18:00 09/08/2021 19:00 WORK

Service Codes
Code Category Description

Multi Asset/Location
Equipment SW EC/
Asset Description Model Serial Number Version Batch# Meter Unit Hospital Asset No
186832 WELCH DS45-11C 180613012948
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186834 WELCH DS45-11C 191007153447
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186833 WELCH DS45-11C 170927222629
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186837 WELCH DS45-11C 170930084727
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186835 WELCH DS45-11C 191004062407
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186831 WELCH DS45-11C 190827082218
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER
186836 WELCH DS45-11C 170526061019
ALLYN=DS45-11C=ANEROID
SPHYGMOMANOMETER

Spare Parts
Part number Part name Serial / LOT number EC/Batch Date Qty Storeroom

Test Equipment toolqty toolhrs

Tool # Tool Serial Number Calibration Due Date Quantity Hours

TO-754 FLUKE=PROSIM 4=VITAL SIGNS SIMULATOR 5093048 16/09/2021 1 01:00

Page 1 / 2 10 Aug 2021 11:11

Hospinorm Maintenance Management, LLC
Techno Hub2, Dubai Silicon Oasis
Tel: +971 4 313 7000 | Fax: +971 4 501 4100
Toll Free: 8004981
A subsidiary of Gulfdrug L.L.C
Email: service@hospinorm.com

Service Report
No : SR-501490-2
Hospital / Medical Center
Name : YAS CLINIC - KHALIFA CITY ABU DHABI Address :
Account Number : IY04 Location / Department : Yas clinic

Work Log
Created By Created Date Description Details
2778 09/08/2021 Installation Installed the 7 sphygmomanometer successfully.
Unit in good working condition for use.

Client Log
Created By Created Date Description Details

Customer Biomedical Hospinorm

Page 2 / 2 10 Aug 2021 11:11