Planned Preventive Maintenance (PPM)
Checklist
Device Information
Device Name: Patient Monitor (Example: Mindray V12)
Asset ID / Tag No: _______________________
Serial Number: _______________________
Location/Dept: _______________________
PPM Checklist Procedure
ID Category Description Pass/Fail/NA
1 Visual Inspection Check casing,
screen, cables, and
connectors for
physical damage.
2 Power & Battery Check power cord
condition. Perform
battery
capacity/charge
test.
3 Electrical Safety Perform ground
continuity & leakage
current test (IEC
60601).
4 Display & Alarms Verify screen clarity,
touch sensitivity,
and audible/visual
alarms.
5 Performance Verify parameters:
Testing ECG, SpO2, NIBP
against simulator.
6 Cleaning Clean device
exterior with
hospital-approved
disinfectant.
7 Finalization Affix "PM Pass"
sticker and update
maintenance log.
Technician Name: _______________________ Signature: _______________________
Date of PM: ___________________________ Next PM Due: _____________________