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BECKMAN
COULTER.
FIELD SERVICE REPORT
Beckman CoulterIndia Pvt. Ltd.
23087
No.: Date 2 o1laD
CUSTOMER NAME: MODEL: NoioS
Couae SERIAL NO: AvoS O022
WARRANTY ACTIVE OwNED OTL | INSTANCE NO:
|SERVICE REQUEST NO. (S.R NO.): -O190713O
TASK NO:
DEPARTMENT: Lwytometi DATE TIME TYPE OF CALL
CONTACT PERSON: o S wtt COMPLAINT RECD INSTALLATION
ADDRESS: |RESPONSSE |24/0 : DE-INSTALLATIONN
Ptne yto met COMPLETION 5lo 126 PM VISIT
HRS MINS BREAKDOWN
CITYIPOSTAL CODE: LABOUR HRS 6D MODIFICATION
STATE/ CoUNTRY: Wet Bego TRAVEL HRS APPLICATION
MOB.TEL. No.: TOTAL HRS
E- MAIL:
PROBLEM REPORTED/SYMPTOM: Mod Ype-s, Releose o Win t To
N MS 4 alu os
OBSERVATIONS/ CAUSE A

ACTION TAKENI RESOLUTION: Beeng a ot n s tvmer u s tomer S t mur

tda s prde o i t s Ov pid Prooke ame lhey hare o

VERIFICATION OF REPAIR: Rm 2 ANA i s pas Sweo

VERIFICATION STATEMENT: () THE COREECT OPTION
Service activity performed is verified to meet the specified requirements as per established procedures. Results meet published

performance specifications.
Documented Verification in Service Report Debrief Notes.
Verified as per established procedures.
OR CUSTOMER STOCK
FOLLOVWING PARTS HAVE BEEN REPLACED FROM - BECKMAN COULTER
DESCRIPTION UNIT PRICE QTY TOTAL NS
Sr. No. PART No.

4
(Taxes Extra) TOTAL Rs.

ADDITIONAL COMMENTS;

TYPE-
RAISED Y / N I F
YES CF
CF
DB. SHYAMALLDUATA
the above charges,
W e approve carried out to my satisfaction.
MB,D.HAmaonathology
work has been
above
I certify that the

CHECKED BY CUSTOMER SIGNATURE

ENGINEERS NAME &SIGNTURE
Market city, LBS Road, Kurla (West), Mumbai- 400 070
s Eea: Unit Nos.TF-B-07(A) to 15 Third Floor, Wng 5, Art GUld House, Phoenix
Telephone: 6838 5000, Fax: 6838 5060/61