FIELD SERVICE REPORT

www.beckmancoulter.com

ACCOUNT MODEL SERIAL NUMBER ID NUMBER

INSTITUTE OF LIVER AND BILIARY DxC 600 Pro 5816 4270937
SCIENCES
ILBS D-1 VASANT KUNJ
NEW DELHI DELHI 110070
CUSTOMER CONTACT PURCHASE ORDER PROPERTY NUMBER
Sarvapriya Singh
011-46300000
AGREEMENT TYPE AGREEMENT NUMBER EFFECTIVE DATES
Warranty W4382IN 08-JUN-2015 To 07-JUN-2016
SERVICE REQUEST NUMBER REQUEST DATE CALL COMPLETE DATE
25956029 04-JAN-2016 04-JAN-2016
PERFORMED BY
Khushanawas Siddiqui
FIELD SERVICE ENGINEER
DESCRIPTION OF WORK PERFORMED
PROBLEM: PM
SOLUTION: 07-JAN-2016 - PM completed done cleaning alignments replacement of PM items and after that photo meter alignments
done calibration and QC all the results found satisfactory.
SYSTEM VALIDATION: For Medical Devices - Regulatory requirements call for a final validation of instrument repair and system readiness. The final validation of
instrument repair and system readiness can only be obtained through a successful QC run using the laboratory's quality control system. This repair record and the laboratory's
quality control records comprise the quality documents associated with this instrument repair. Copies of these records may be required by Beckman Coulter or regulatory
authorities to complete technical investigations or quality audits. We appreciate your cooperation if requested to provide copies of your QC data related to this repair.
EXTENDED CUSTOMER
DATE DESCRIPTION TYPE HOURS RATE AMOUNT CHARGE
04-JAN-2016 02-PM Labor TRAVEL 2.00
04-JAN-2016 02-PM Labor LABOR 11.00
04-JAN-2016 02-PM Labor TRAVEL 1.92
LABOR/TRAVEL TOTAL
EXTENDED CUSTOMER
PART NUMBER PART DESCRIPTION QTY PRICE AMOUNT CHARGE
758407 CX4CE/7 CUVETTES (PKG/10) 1
A08915 Drive Assembly, DxC Reaction 1
A09397 Dual Motor Driver Smart Module 1
A45723 Motor Assembly, Lifter - DxC 1
A37244 DxC 600 Preventive Maintenance Kit, (ISE/MC) 1
A83860 Preventive Maintenance A Kit - DxC 600/800 1
B16493 Pump Service Kit 1
B21550 Level Sense Kit, Reagent Crane - DxC 1
TOTAL CHARGE
CUSTOMER SIGNATURE

Total is an estimate only and does not include any tax or local levies.

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