CARDIO LINE 400/400 MED
Technical and optical modifications as well as misprints reserved - © 2019 by ERGO-FIT GmbH & Co. KG
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Registration of medical devices add-in card
Operator: __________________________________________
__________________________________________
__________________________________________
1. Designation of the medical device:
_________________________________________________________________
2. Functional test and introduction:
Functional test carried out
on: ________________ by: __________________________________________
Introduction carried out
on: ________________ by: __________________________________________
Introduced person: ____________________________________________
____________________________________________
____________________________________________
3. Metrological inspection: at least every two years
Next inspection: ___________________________________________________
by (person‘s name: ________________________________________________
4. Safety inspection/maintenance test: recommendation every 12 months
Next inspection: ___________________________________________________
by (person‘s name: ________________________________________________
5. Date, type and consequence of the defect and repeated identical operating fault:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
6. Reports of incidents to authorities and manufacturer:
_________________________________________________________________
_________________________________________________________________
