BECKMAN FIELD SERVICE REPORT

COULTER,_
Beckman Coulter India Pvt. Ltd. No.: 30867 Date: 1407
CUSTOMER NAME: MS Sm Hstzdls MODEL: DA Plo1
SERIAL NO: AD30 107
WARRANTY: ACTIVE OWNED OTL
INSTANCE NO: 78870423
SERVICE REQUEST NO. (S.R NO.) Wo-0339616 6
TASK NO:
DEPARTMENT flae tpmutr DATEDATE TIME TYPE OF CALL

CONTACT PERSON: COMPLAINT RECD INSTALLATION

ADDRESS: RESPONSSE 407 1320DE-INSTALLATION
k-8
Rlinga COMPLETION l74.nPM VISIT
HRS MINS BREAKDOWN
MODIFICATION
CITY/PoSTAL CODE BmboenAN /7sibs LABOUR HRS
|APPLICATION
STATE COUNTRY: Odlisthas aia TRAVELHRS
MOB.TEL. No.: 776 3O4119 TOTAL HRS
E-MAIL:
PROBLEM REPORTED/ SYMPTOM: Prrewenre miml lo be dne

OBSERVATIONS/ CAUSE Prvhre aintenaru peami m Derh PM

PaiLdre
ACTION TAKEN/ RESOLUTION:

|VERIFICATION OF REPAIR:
a - n a beodo k pam H

OPTION
VERIFICATION STATEMNT: V)THE COREECT requirements as per established procedures.
Results meet published
performed is verified to meet the specifñed
Service activity
perfomance specifications.
Report Debrief Notes.
Verified as per established procedures. Documented Verification in Service
OR CUSTOMER STOCK
PARTS HAVE BEEN
REPLACED FROM -BECKMAN COULTER
FOLLOWING UNIT PRICE QTY TOTA NS
DESCRIPTION
| Sr.No. PARTNo.

(Taxes Extra) TOTAL Rs.|

ADDITIONAL COMMENTS:

C F RAISED Y/N IF YES CF TYPE -

Wapprove the above charges. carried out to my satisfaction.

work has been
I certify that the above
wwm haxrossy
CUSTOMER SSNATURE
CHECKEDBY
ENGINEERS NAME SIGNATURE
Mumbai- 400 070
LBS Road, Kurla (West),
Market city,
Nos.TÉ-BÓ7(A) to 15 Third Floor, Wing B, Art Guild House, Phoenix
Fax: 6838 5060/61
Head Offce: Unit Telephone: 6838 5000,