Asha

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SERVICE REPORT

SHIUA HEALTHCONSUMABLES
GARE, Serial No.
141
& Patna(Bihar+800020
CRITICAL CARE EQUIPEMNTS
Near Modern Hospital, Complaint No.
House No. A-170,9155817090,
7070096824
2nd Floor, P.C. Colony.
7070096822, 9264196991
CUSTOMER INFORMATION

CUSTOMERDETAILS E-MAIL:
(M)
CONTACT DETAILS PRODUCTINFORMATION SW VERSION
OPERATING HOURS
COMPRESSOR
MACHINE
MODEL:
SERIAL NO. NO
WITHIN WARRANTY YES
WARRANTY STATUS: VISIT CHARGES:
NO
CMC IAMC STATUS:
YES Breakdown Call

REASON FOR VISIT: PM


PROBLEM INFORMATION

PROBLEM IDENTIFIED

CORRECTIVE ACTION TAKEN

REPLACEMENT
REPLACED I/ NEED
PARTS/ CONSUMABLES / Qty. |Unit Price Total
Price (INR) Taxes Extra
Description of the Parts
SI. No. Part No.

ENGINEER'S REMARKS

stgnature
Date: CUSTOMER'S REMARKS

Signature & Stamp


Date:
Customer Name:

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