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    PTR 0157 - 910008619

    Uploaded by

    Gunma Akagi
    This document is a purchase/technical report form requesting the replacement of a battery pack for an infusion pump. [1] It details that the battery is depleted and needs replacing with a 12V 1800mAh battery. [2] The form provides information on the asset such as the model, serial number, and manufacturer. [3] Engineering comments note the exact problem and troubleshooting steps taken.

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    PTR 0157 - 910008619

    Uploaded by

    Gunma Akagi
    50 views2 pages
    This document is a purchase/technical report form requesting the replacement of a battery pack for an infusion pump. [1] It details that the battery is depleted and needs replacing with a 12V 1800mAh battery. [2] The form provides information on the asset such as the model, serial number, and manufacturer. [3] Engineering comments note the exact problem and troubleshooting steps taken.

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    This document is a purchase/technical report form requesting the replacement of a battery pack for an infusion pump. [1] It details that the battery is depleted and needs replacing with a 12V 1800mAh battery. [2] The form provides information on the asset such as the model, serial number, and manufacturer. [3] Engineering comments note the exact problem and troubleshooting steps taken.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    50 views2 pages

    PTR 0157 - 910008619

    Uploaded by

    Gunma Akagi
    This document is a purchase/technical report form requesting the replacement of a battery pack for an infusion pump. [1] It details that the battery is depleted and needs replacing with a 12V 1800mAh battery. [2] The form provides information on the asset such as the model, serial number, and manufacturer. [3] Engineering comments note the exact problem and troubleshooting steps taken.

    Copyright:

    © All Rights Reserved
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    You are on page 1of 2

    SEDAFIAT SDN. BHD.

    PURCHASE / TECHNICAL REPORT FORM (PTR) BEMS

    NO. ITEM QUANTITY ENGINEERS / TECHNICIAN COMMENTS:


    1 PTR No. : PTR/BEMS/ TWU/22/0157 Exact Nature of problem observed:
    2 PTR Date : 19.04.2022 Battery depleted need to replace.
    3 Item Request 1 : Battery Pack 12V, 1800mAh 1
    4 Part No. Item 1 : BP-23
    5 Item Code :
    6 Item Request 2 :
    7 Part No. Item 2 :
    8 Item code :
    9 Asset Category : General
    10 PTR Category : Spare Part
    11 SR No. : SR/SBH910/20220408/B003380 Troubleshooting steps taken :
    12 WO No. : WO/BEMS/SBH910/2204/000020
    13 WO Date : 08.04.2022
    14 Asset No. : 910008619
    15 Asset Description : Infusion Pumps, General-Purpose
    16 Model/brand : TOP-2300
    17 SN No. : 16A0825
    18 Manufacturer : TOP Corp
    19 Purchase Date : 02-Nov-2016
    20 Purchase Price : 3800.00

    OCW PERSONNEL COMMENTS :


    ACTION TAKEN :
    to be filled by OCW

    RECOMMENDATION :
    to be filled by OCW

    REQUESTED BY: VERIFIED BY: RECEIVED BY:

    NAME: ROZAINI KASSIM OPERATIONAL CENTRAL WORKSHOP TENDER, CONTRACT, PROCUREMENT &
    DEPARTMENT: LOGISTIC DEPARTMENT
    BEMS TAWAU
    DATE: 19.04.2022 DATE: DATE:

    I ACKNOWLEDGE RECEIPT TO THE ABOVE MENTIONED REQUESTED BY ME

    SIGNATURE :

    DATE :

    Ref No.: TPL(301)F5 Revision No.: 1 Effective Date: 01/04/2015


    Page 1 of 1
    SERVICE WORK (UNSCHEDULED & OTHERS)
    BEMS

    A. Request Details

    Hospital Name / Code Tawau / SBH910 Priority Normal

    Service Work No. WO/BEMS/SBH910/2204/000020 Service Request No. SR/SBH910/20220408/B003380

    Category Unscheduled Type Corrective Maintenance

    Request Date / Time 08-Apr-2022 09:58 Requestor Name Normah Binti Pani Rahman

    Requestor Location Name Female Medical 2 - Air Lock Designation Nurse Contact No. 8458

    Asset No. 910008619 Asset Name Infusion Pumps, General-Purpose

    Asset Location Code / Name 60GF002 / Female Medical 2 - Air Lock Type Code 13-215
    UP12 / Level 1 / Female Medical 2 & PSY Department Code /
    User Area Code / User Area Name I02 / In-patient Care Services
    Ward Department Name
    Manufacturer TOP Corp Brand / Model TOP / TOP-2300

    Workgroup W2-Biomedical Engineering Variation Status

    Request details To check and repair Infusion Pumps, General-Purpose error alarming at Female Medical Ward, Loc : 60GF014

    B. Contract/Warranty Information

    Contractor Name Contractor Code

    Contact Person Phone No.

    Start Date End Date

    C. Assessment Details

    Response By Rozaini Binti Kassim Date 08-Apr-2022 Time 10:30

    Response Finding machine alarming over

    User Verification By Date/Time


    Signature / Department stamp

    Asset Working Status ¨ Functioning þ Not Functioning ¨ Partially Functioning

    D. Part Details

    No. Part No. Part Description Qty

    E. Employee Details

    No. Staff ID Name Start Date/Time End Date/Time

    F. Process Status

    ¨ Propose for BER ¨ Propose for RW ¨ Equipment In Use ¨ Technical Advise ¨ Equipment not at location

    ¨ Loaner Provision ¨ Alternative Service

    G. Completion

    Performance Test ¨ Done ¨ Not Applicable ¨ Not Done Electrical Safety Test ¨ Done ¨ Not Applicable ¨ Not Done
    Date/Time Work
    Date/Time Work Start
    Completed
    Action Taken

    QC Code

    Completed By Verified By (MoH)

    Signature / Date Time Signature / Date Time

    Date:19-Apr-2022 09:16

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