Inventory form
Inventory #: __________________________________________________________________
Type of Equipment: ____________________________________________________________
Manufacturer: _________________________________________________________________
Model: ____________________________ Serial no. _______________________________
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 _____________________
Equipment Users: Doctors Nurses Lab Technicians Students
Equipment owner (department), if any: ___________________________________________
Contact Person and Telephone numbers: __________________________________________
Current location of equipment: __________________________________________________
Will it move from here? No Yes If so, where? _____________________
