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Pediatric Equipment Maintenance Log and Tracking System

Comprehensive Documentation Template for Medical Equipment Management

Pediatrics

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Template Content

Last updated: Mar 24, 2025

Equipment Information

  • Equipment Name: ________________
  • Model Number: ________________
  • Serial Number: ________________
  • Location: ________________
  • Purchase Date: ________________
  • Warranty Expiration: ________________

Maintenance Schedule

Date Due Maintenance Type Completed Date Technician Notes
□ Calibration
□ Cleaning
□ Safety Check
□ Parts Replacement

Critical Equipment Parameters

Safety Checks

  • Electrical Safety: □ Pass □ Fail
  • Physical Integrity: □ Pass □ Fail
  • Calibration Status: □ Pass □ Fail

Performance Verification

  • Accuracy Test: □ Pass □ Fail
  • Function Test: □ Pass □ Fail

Repair History

Date Issue Description Resolution Cost Service Provider

Compliance Documentation

  • Last Inspection Date: ________________
  • Next Inspection Due: ________________
  • Certification Number: ________________
  • Inspecting Authority: ________________

Emergency Contacts

  • Service Provider: ________________
  • Phone Number: ________________
  • Account Number: ________________

Notes and Observations

Maintain this log in accordance with facility policies and regulatory requirements.

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