QO secman FIELD SERVICE REPORT COULTER, Beckman Coulter India Pvt. Ltd. No.: 80937 pate: (Sub TUSTONERNANE: —_Alrmnenl PAazanacetficad MODEL: [513320 SERIALNO, AV 34796 TRY TET OWNED on INSTANCENO! 37/8158 aan SERVICE REQUESTNO.(SRNO) WO=093/92235 TASKNO: 2A) — 044 89520 _ DEPARTNENT: Gap DATE [TIME TYPE OF CALL CONTACT PERSON: PAVIA ION COMPLAINTRECD |_— INSTALLATION "ADDRESS: Pharmacy = Carkhey RESPONSE (gfo7 | 7 DE-INSTALLATION COMPLETION e]0 730 [PM VISIT Z| Sota Wiyhuder » [ a Hh [BREACOOWN TIN IPOSTAL CODE: Athrneda bo ck LABOUR HRS 6___|22_| MODIFICATION STATEICOUNTRY: Gaye Doha TRAVEL HRS: 4 —|79__| APPLICATION MOBTELNe: 76 9 F626 260” TOTAL HRS jo [7 EMAL: Aerddapdyl @ Qmnd rol ater PROBLEM REPORTED/ SYMPTOM : Prever te. tnminbersnet OBSERVATIONS) GAUSE NA AGTION TAKEN/ RESOLUTION : Prevede_preirlen Pon me Per de _ Orrin Fenpance, [recede a ‘ a I PES re ab 2 fe VERIFIGATION OF REPAIR, Pat mle GIS, [Spore 4 2B Sod bendy and del 1S Jarmd Sb ef bs + VERIFIGATION STATEMENT: (7) THE COREECT OPTION [LiService activity pertormed is verified To meet the specified requirements as por established procedures. Results mest published performance specifications [ey ierifed as per established procedures. Documented ‘Verification in Service Report Debrief Notes. FOLLOWING PARTS HAVE BEEN REPLACED FROM: BECKMAN COULTER “CoT_or customer stock LJ SeNo| _PARTNo. DESCRIPTION unitprice_|_ary TOTAL NS 4 i pb 2 : RA 4 wi. (Taxes Extra) TOTALRS. ADDITIONAL COMMENTS: Q YY Compt) AucerY othe GERASED YIN FYESCRTVPE. A ee ‘vty tat above wok has been cated out to my sat (] Byahrrarerda (hou Toh oe I (grue Ve Banh rence eae SMENATURE cneckeo BY “DUSTOMER SIGNATURE ‘ood oma: Unt Nou. TF--07() 018TH Fler, Wing 8, At Gul Hout, Prose Markt cy LBS Roa, Kl (West, Mumbo 100 070 *Teiepnone! 838 6000, Fax: 6838 SO6O'St