Medsource Ozone Biomedicals Pvt.

Ltd
DATE:

Pre-Installation Report

Customer Name & Address

Contact No.
Present Installation Site Details
1. Room Size :- Length: Ft.
Width: Ft.
2. Table Or Floor Size For The HUMAN Instrument:Length: Ft.
Width: Ft.
3. Window Position: Near To Instrument: - Yes
No.
4. Other Instruments In That Room:-

Height :Height :-

5. Any Centrifuge Instrument Installed In That Room :- Yes

No.
Distance Of Centrifuge From Human Instrument at Proposed Site:6. Whether Air Conditioning Instrument Is Installed :- Yes
No.
7. Power Rating Of UPS :- Online
Offline
Rating:VA, Max. Load:Voltage:Volt, Grounding Voltage:8. Humidity Condition:

Volt, Frequency:-

Hz, Backup:-

Ft.
Ft

VA
Minuts

9. Engineers Opinion (Suggested changes on site if any) :10. Engineers Recommendation:11. Planned Date Of Installation :Customers Remarks:-

Name of Engineer:-

Name of Customer:-

Siganture of Engineer:-

Siganture of Customer With Seal :-

238, Sant Nagar, East of Kailash, New Delhi-110065 India Phone: 91-11-51624142, 51624387, 26433880
Fax: 91-51624083 Email: msrinivas@Ozonebio.Com Website: Www.Ozonebio.Com