PT,GE Operations Indonesia

South Quarter Tower B,Lantai 18-19,

Jl.R.A Kartini Kav 8
Cilandak Barat Cilandak
Jakarta selatan DKJ,Jakarta 12430
T +6221 5730500
F +6221 80649817
Service Report www.gehealthcare.com

Customer Details

Customer Name: 3964574 - Bogor Senior Hospital

Equipment Location: Jalan Raya Tajur Blok Gudang Garam No.168, Sindangrasa, Bogor Selatan, Bogor, Jawa Barat, Indonesia, 16137
SO No: 5096503 Contract Class: N/A
Contact Name: -- Report Type: Installation
Contact Phone: -- Request No.: 1-9889611179
Contact Email: -- Purchase Order No.: 5096503
SID #7982XR0532Install at Bogor Senior
HospitalService Installation completed as per<Title
Initial Problem Description: Contract End Day: N/A
of service manual> - <Reference number of Service
Manual>

Equipment Details

Initial Equipment Status: 3 - System Running System ID: 7982XR0532

Product Description: OEC ONE II V2 STD Serial No.: --
Customer Eq#: --

Activity

Activity #: 1-4JK20MU Close Date: --

Activity Type: Installation Field Engineer: Yohanes Sakti
Reported Problem: perform radiation room leakage test
Identified Problem: --
Solution: perform radiation room leakage test
Test Procedure: system test with user, Ok
Test Passed: Y

Labor

DATE TYPE START TIME - END TIME HOURS OT

12 Jan. 2022 Customer Application 10:00:00 - 13:00:00 3.00 --

Materials

No Materials

Engineer Signature:

Engineer Name: Yohanes Sakti

Date/Time: 12-Jan-2022 12:08

Customer Name: Ari Customer Name: Aldila Riska Putri

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 PT,GE Operations Indonesia
South Quarter Tower B,Lantai 18-19,
Jl.R.A Kartini Kav 8
Cilandak Barat Cilandak
Jakarta selatan DKJ,Jakarta 12430
T +6221 5730500
F +6221 80649817
Service Report www.gehealthcare.com

Customer Name: Ari Customer Name: Aldila Riska Putri

Date/Time: 12-Jan-2022 12:09 Date/Time: 12-Jan-2022 12:09

Customer Signature 1 Customer Signature 2

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