BECKMAN

COULTER. FIELD SERVICE REPORT

Beckman Coulter India Pvt. Ltd. 23094
CUSTOMER NAME: Trs Pabhat No.:
Date: haapa
Roman MODEL: NoNiog
WARRANTY ACTIVE OWNED
OTL
SERIAL NO: AN270g
INSTANCE NO:
693 SIbY
SERVICE REQUEST NO. (S.R NO.):
DEPARTMENT: TASK NO: W0-029 9120
CONTACT PERSON: Mo Serdok. DATE TIME TYPE OF CALL
|ADDRESS: | COMPLAINT RECDuD2 4:go |INSTALLATION
Kankarbagu RESPONSE 02 IS:00 DEINSTALLATION
COMPLETION o l6 oo PM VISIT
HRS MINS BREAKDOWN
CITYI PoSTAL CODE Patna | LABOUR HRS
STATE/ cOUNTRY: MODIFICATION
TRAVEL HRS
MOB.TEL. No.: 8356 78234 TOTAL HRS
o0APPLICATION
E- MAIL
PROBLEM REPORTED/ SYMPTOM
No evens

OBSERVATIONS/ CAUSE: Sample orbe blo ned

ACTION TAKEN/ RESOLUTION: CLamid Ursampi_rbe D !D1 Wali

VERIFICATION OF REPAIR Rom AC baaslo am a c is P

Swecesuly
VERIFICATION STATEMENT: (THE COREECT OPTION
|Uservice activity performed is verified to meetthespecifedrequirementsas perestablished procedures. Results meet published
performance specifications.
LVerified as per established procedures. Documented Verification in Service Report Debrief Notes.
FOLLOWING PARTS HAVE BEEN REPLACED FROM-BECKMAN COULTER OR CUSTOMER STOCK
Sr. No. PART No. DESCRIPTION UNIT PRICE QTY TOTAL NS

(Taxes Extra) TOTAL Rs.

ADDITIONAL COMMENTS: Reepmedes wpe pat lu

8lmce Cmre-t*
CF RAISED Y/N IF YES CF TYPE -

We approve the above charges.

I certify that the above work has been carried out to my satisfaction.
Phtmande Haugbr
blo3a). a x T m b o
Hod Sae
1//
ENGINEERs NAME &SIGNATURG CHECKED BY CUSTOMER SIGNATURE

Head Office: Unit Nos.TF-B-07(A) to 15 Third Floor, Wing B, Art Guld House, Phooni Market city, LBS Road, Kurta (West), Mumbai- 400 070
Telephone: 6838 5000, Fax: 6838 5060/61