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Einlegekarte für das Medizinproduktebuch
Betreiber: ___________________________________________________
___________________________________________________
___________________________________________________
1. Bezeichnung des Medizinproduktes: ___________________________
2. Funktionsprüfung und Einweisung:
Funktionsprüfung durchgeführt
am:________________ von:______________________________
Einweisung durchgeführt
am:________________ von:_______________________________
Eingewiesene Personen:
___________________________________________________
___________________________________________________
___________________________________________________
1. Messtechnische Kontrollen: spätestens alle 2 Jahre Nächste: ______
Durchführung: ___________
Sicherheitstechnischen Kontrollen: spätestens alle 12 Monate
Nächste Durchführung: ______________________________
Durchführende Person: ______________________________
2. Datum, Art und Folgen von Funktionsstörungen und wiederholten gleichartigen
Bedienungsfehlern:
3. Meldungen von Vorkommnissen an Behörden und Hersteller.
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