BIOLAF INDONESIA

Plaza Victoria Blok A No 11, Babakan Madang, Bogor 16810

Phone :021- 87953793 Fax : 021-87953794

No :
Date :
SERVICE REPORT
Customer :
Instrument : Serial No :

Problem :

Mechanic. Electronic. Miscellaneous.

Service-
Calibration

Repair-
Overhoul.

Parts – Replacement :

Status : Ok
Problem Note :

Start – Service/ Repair :

End – Service/Repair :
Service/Repair – Charge :
Parts – Replacement :

Name and Signature, Name and Signature,

Technician Customer

(………………………) (………………………)