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Inventory Data Collection Form

The document is an Inventory Data Collection Form used to gather essential information about equipment, including its type, manufacturer, model, condition, and maintenance needs. It also collects details on spare parts availability, manuals, equipment users, and contact information. This form is intended for use by the Biomedical Engineering Department.

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Fikadu Tuji
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20 views1 page

Inventory Data Collection Form

The document is an Inventory Data Collection Form used to gather essential information about equipment, including its type, manufacturer, model, condition, and maintenance needs. It also collects details on spare parts availability, manuals, equipment users, and contact information. This form is intended for use by the Biomedical Engineering Department.

Uploaded by

Fikadu Tuji
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Inventory Data Collection Form

Inventory # ________________________

Type of Equipment: __________________________________

Manufacturer: _____________________________

Model: _________________ Serial #: ____________________

Country of Origin: ________ Year of Manufacture: __________

Power Requirement: 220V 110V

Current State/Condition: Operable and in service

Operable and out of service

Reason out of service: _______________

Needs maintenance

Not repairable

Needs to be discarded? Yes No

Spare parts available? Yes No

If yes, what, how many, and where are they located? _________________

___________________________________________________________

Manuals Available: User manual # of copies _______ Location ____________

Service manual # of copies _______ Location ____________

Other (specify) # of copies _______ Location ____________

Equipment Users:

Doctors Nurses Lab Technicians

Students Residents Other (specify) ____________

Equipment owner (department), if any: ____________________________

Contact Person and Telephone numbers: __________________________

_____________________

Current location of equipment: __________________________________

Will it move from here? No Yes If so, where? ________________________

Other notes: ___________________________________________________________

___________________________________________________________

BIOMEDICAL ENGINEERING DEPT. SCHPH

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