Date: 8-06-2022

EQUIPMENT DEMONSTRATION FEEDBACK FORM

This is to certify that performance of following equipment presented for demonstration

purpose in our institute is excellent and upto the mark.

Name of Equipment: ICU Ventilator

Model: Elisa 500

Make: Lowenstein Medical – Germany

Institute: PIMS (Pakistan Institute of Medical Sciences)

Hospital , Islamabad.

Comments of the End User:

Signature: ______________________

Stamp: ________________________