Job Card HOSPITAL WORKSHOP
Date _________________
Hospital ________________________________________ Repair
Department ________________________________________ Maintenance
Contact Person ________________________________________ Installation
Phone Number ________________________________________ Emergency
Equipment _________________________ Model _______________________________
ID / Serial Number _________________________ Accessories _______________________________
Problem Description __________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Date Hours Description of Work
Work
__
Materials used Price per Item Total Price
Spare Parts
Consumables (cleaning material, grease, solder, glue, cable ties, screws)
Total
Date Hours km Comments
Mileage
Repaired by (Technician) _____________________ Signature _________________ Date ____________
Received by (Customer) _____________________ Signature _________________ Date ____________
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