Appendix
A
Functional check form, Datex-Ohmeda S/5 AM, CCM
A1(4)
Document no. M1137263-04
APPENDIX A: Functional check form,
Datex-Ohmeda S/5 AM, CCM
OK = Test OK
N.A. = Test not applicable
Fail = Test failed
Customer
Service
Service engineer
Date
Measuring equipment / test gases used:
Equipment / tool / gas:
Manufacturer:
Model/Type/Part
Number:
Serial Number /
ID:
Calibration
Date:
Monitor Installation
F-CU5(P)
B-
N-
F-CPU
B-
N-AC
B-
F-CU8
B-
L-
K-
D-
D-
Visual Inspection
OK
N.A.
Fail
Functional Inspection
OK
N.A.
Fail
S/N
S/N
Summary of Contents for Datex-Ohmeda S/5
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Page 431: ...Spare parts 9 Document no M1137274 01 3 2 Central Processor Unit for F CU5 F CPU 02 ...
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