MammoReport Plus
Report
SP
© Siemens AG 2005
The reproduction, transmission or
use of this document or its contents
is not permitted without express
written authority. Offenders will be
liable for damages. All rights,
including rights created by patent
grant or registration of a utility
model _or_ design,_are_ reserved.
English
Print No.: SPB7-420.813.20.01.02 Doc. Gen. Date: 02.05
Replaces: n.a.
2
1
Installation Protocol
Fax Message
(please send the document to:)
CAUTION IT IS ABSOLUTELY MANDATORY TO ENTER ALL REQUESTED DATA
IN THIS PROTOCOL WHEN THE INSTALLATION OF THE SYSTEM WAS
COMPLETED! INCOMPLETE PROTOCOLS WILL BE RETURNED TO
YOUR SUPERVISOR FOR FOLLOW-UP!
Equipment Type MammoReport Plus..............................................
System serial no.: Order Number:
Customer/Hospital Name: ............................................................
City: ................................................................
Country/State: ................................................
SIEMENS AG Medical Solutions; Dept. SP SCM
Fax no. +49 - 9131 - 84 - 8893
91050 Erlangen, Henkestr. 127, Germany
Confirmation: I hereby certify that
¹ The system indicated above was delivered in its entirety. Installation and Startup
were performed accordding to the actual version of the installation and startup
instructions as delivered with the system (please indicate any deviation in the
table below).
¹ All safety and functional checks have been performed.
¹ All required measurements have been made and the values are within tolerance
as provided by the manufacturer.
Installation Problems Brief description
yes no
Workstation
Cabling
Options (e.g. Hard disk)
Others
Start-up
Workstation
Networkconfiguration
Image quality
Others
(please mark with ‘n.a.‘ if not applicable)
Please add additional pages for description, if necessary.
_______________________________________________________________________
Printed name of system installer date signature
MammoReport Plus SPB7-420.813.20 Page 2 of 2 Siemens AG
Rev. 01 02.05 CS PS 24 Medical Solutions