BECKMAN

COULTER FIELD SERVICE REPORT

Beckman Coulter India Pvt. Ltd. No. Date: 17/o3/202
CUSTOMER NAME: Arm Hzspia- MODEL: Nowio sEy
SERIAL NO: Bp21562
WARRANTY ACTIVE OWNED OTUCONTRACTS INSTANCE NO; 76544461
SERVICE REQUEST NO: Wo-030 491|
TASK NO:
DEPARTMENT: emato oq DATE TIME TYPE OF CALL
CONTACT PERSON: . MamichaAsrd COMPLAINT RECD al3 al3oINSTALLATION
ADDRESS: RESPONSE 3 |11:S|DE-INSTALLATION
Arm H1pit (F-) COMPLETION 1al3 162D | PM VISIT
HRS MINS BREAKDOWN
CITY/POSTAL CODE: Kolual LABOUR HRS MODIFICATION
STATE COUNTRY: Wet Bent al_ TRAVEL HRS 2 0 APPLICATION
MOB/TEL No: TOTAL HRS 6 o DEMO/OTHERSS
E-MAIL:
|PROBLEM REPORTED/SYMPTOM:

OBSERVATIONS/CAUSE:
ACTION TAKEN/ RESOLUTION Cnw h s o r y p y SRwn
meo m ualy m) dispu
P iPiedy-
VERIFICATION OF REPAIR: Rovm

VERIFICATION STATEMENT: Sq¢lumDi rami _ ao_por 0

FOLLOWING PARTSHAVE BEEN REPLACED FROM-BECKMAN COULTER OR CUSTMER STOCK

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

1.

2.

4.
(Taxes Extra) TOTAL Rs.

|ADDITIONAL COMMENTS:

CF RAISED Y/N IF YES CF TYPE.

We approve the above changes.
I certify that the above work has been
carried out to my satisfaction.

ramnmeda KAaugebr
ENGINEERS NAME &6IGNATURE CHECKED BY
CUSTOMERSIGNATURE
a d Hfice:(Unit Nos.T8-07(A)to 15, 3rd Floor, BWing. Art GuildHouse Phoenix Market City, LBS Road KurlaWest,Mumbai-40
Tel: +91 22 3080 5000 Fax: +91 22 3080 s060
Toll Free Number: 18002009340 Email: belsservice@beckman.com