BECKMAN FIELD SERVICE REPUKT

COULTER. . 23078
Beckman Coulter Indla Pvt.Ltd. No.: Date: 04loil81
CUSTOMER NAME : Apollo GluanmeokzMODEL:Fcsoo
Hestnts SERIAL NO: AS2 7106
WARRANTY ACTIVE OWNED OTL INSTANCE NO: 13 SO 811
SERVICE REQUEST NO. (S.R NO.)_ Wo-02616368
TASK NO:
DEPARTMENT: Elowe e t n DATE TIME TYPE OF CALL
CONTACT PERSON:
M. AT COMPLAINT RECD INSTALLATION
ADDRESs
38 Cmab irmlar RESPONSE 04lo | n oDE-INSTALLATION
04/0 Is:00PM VISIT
Rond, COMPLETION
HRS MINS BREAKDOWN
CITY/POSTAL CODE: KouLaln -706 0SY LABOUR HRS 3 00 MODIFICATION
STATE/ COUNTRY: Wes Berpal TRAVEL HRS APPLICATION
MOB.TEL. No.:
TOTAL HRS
E-MAIL:

PROBLEM REPORTED/ SYMPTOM trewmlive moumlnme bedmi

OBSERVATIONS/ CAUSE: NA
ACTION TAKEN/ RESOLUTION: Prwelws mam temamia Derhamed

VERIFICATION OF REPAIR:
beado

VERIFICATION STATEMENT: THE COREECT OPTION

|UService activity performed is verified to meet the specified requirements as per established procedures. Results meet published
peformance specifications.
Verified as per established procedures. Documented Verificationin Service Report Debrief Notes.

FOLLOWING PARTS HAVE BEEN REPLACED FROM-BECKMAN COULTER U OR CUSTOMER STOCK

Sr. No. PART No. DESCRIPTION UNIT PRICCE QTY TOTAL NS

Taxes Extra) TOTAL Rs.|

ADDITIONAL COMMENTS: Simme i e mainane has been ohsolule o md.

SPmre perB_ one o mre memmkrlnmd re loox fes allinalwa |
CF RAISED Y/N IF YES CF TYPE
-

We approve the above charges.

Icertify that the above work has been carried out to my satlsfactlon.
1.
(Bnrebry
ENGINEERS NAME&SIGNATURE CUSTOMER SIGNATURE

Head Offce: Unit Nos.TF-B-07(A) to 15 Third Floor, Wing B, ArtGuidHouse.PhoenixMarket city, LBS Road, Kurta (Wes), Mumbai- 400 07o
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