Date Of Print: 9/26/2022 8:16:27 AM WO/Status:AAH-PM-202209-01301/PendingVerification

Preventive Maintenance

Work Order AAH-PM-202209-01301 Frequency Every 6 Month(s)

Work Description PPM FOR DEFIBRILLATOR-AA01-066740 Created Date 09-Sep-2022 05:31:56 PM

Location Full Path Department/Section Priority

Al Ain Hospital Medical Institute/Medical 5 4 (Low/PPM/Deferred)

Device Specification Equipment Type: Defibrillator Equipment ID

Serial No.: US00317008 Manufacturer: Philips Defibrillator/SEHA-
0000011280
Installation Date : 21-Mar-2007 Warranty Expiry Date: 21-Mar-2010 Local Asset No:
AA01-066740
Type: CF Model No: HeartStart MRx External Asset No:
38197
RiskLevel:High Supplier: Emirates Technology Company Next PPM Date:01-Mar-
(EMITAC) 2023
TypeOfmaintenance:Contractor Maintenance TypeOfMaintenance SpecialCondition: Previous PPM Date:01-
Mar-2022
Assigned To (Company/Supervisor): Vendor Name: ONE HEALTH Class:Class I

Type of Work PPM-Biomedical Type of Service PM - Medical Equipments

Type of Problem Routine Biomedical Equipment Is the system/equipment down? NO

Yes/No.
Maintenance
If yes, Start Down Time: End Down Time:

Is CM Required? NO If Yes, CM Work ID:

Technical Remarks Physically available in Dialysis.
PPM has been carried out as per the attached SEHA checklist. Checked device functions and
performed EST, Equipment handed over to end user in good working condition.

Man Power Used

SN. Eng / Technician Planned Start Planned End Actual Start Actual End Signature
Date/Time Date/Time Date/Time Date/Time
1 M. Vairamanickam 01-Sep-2022 30-Sep-2022 23-Sep-2022 23-Sep-2022
12:00:00 AM 12:00:00 AM 09:00:00 AM 10:30:00 AM

Comments

End User Engineering Deparment

Name Name:
Signature Signature

Equipment "Approved" For Use Equipment "Not Approved" For Use