MEDICAL TECHNOLOGY BRANCH CALIBRATION SERVICES

MINISTRY OF DEFENCE AND VETERAN AFFAIRS

NAMIBIAN DEFENCE FORCE TRAINING ESTABLISHMENT
VOCATIONAL TRAINING CENTER
MEDICAL TECHNOLOGYBRANCH

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CALIBRATION SERVICES
Name of organisation undertaking Calibration: Certificate id No.
Hospital category: Hospital Dental Sickbay
Reference ID as per inventory:
Hospital Name:
Equipment Name:
Toll free number After scheduled Preventive maintenance
Calibration request via Corrective maintenance
Name:
Year of Manufacturing:
Manufacturer details
Model Number:
Serial Number:
Date: ___/____/_____
Calibration Date
Next scheduled Date: ____/____/_____
Hospital/Onsite Lab Workshop Others
Location at which Calibration is conducted
Others:
Standard operating procedure or protocol followed for calibration as Manufacturer reference
recommended by Manufacturer of medical devices. document No:
In case protocol/SOP are not available from manufacturer, service provider may develop
own protocol,that shall ensure the function of medical device to satisfactory level for use Self-developed SOP No:
in clinical diagnosis/treatment.
External Environmental condition Altitude: Temp: Humidity:
Name: Serial Number:
Tools used for calibration
Name: Serial Number:
Due date: ___ /____/___
Due date of calibration tool
Tracing number:
Parameters Measured Reference Acceptable
Test for electrical safety on medical device (only for
Value range Tolerance
electrical/electronic medical devices) [Standard IEC 60601-1]
Parameters Measured Reference Acceptable
Test on functional parameters of medical device used for Value Tolerance
range
clinical purpose.
Corrective maintenance required
Calibration Result
Acceptable for clinical purpose
Name:
Designation:
Credential of: CE / BMET Other
Signature:
Date:
Name:
Designation:
Credential of RMO/ hospital in-charge officer:
Signature:
Date:
Any remarks on the functional Status of medical devices:

Self-Declaration of Service provider: Staff conducting preventive maintenance behalf of this organisation is trained and qualified enough
to conduct calibration maintenance on above mentioned medical device. Also, tools used for calibration are valid and calibrated with
other equivalent national/international organisation or by Manufacturer of tool.

For any technical problem, notify Medical Technology Branch immediately.

SN Mupandeni LI Mangundu
Clinical Engineering Biomedical Technician
Office: +264 62 509 4151 Office: +264 62 509 4151
Cell: +264 81 324 1950 Cell: +264 81 277 9999
Simeon.Mupandeni@namdefence.org Lazarus.Mangundu@namdefence.org
jimtau@ymail.com
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