Information
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
C-PAP Checklist
-
1- C-PAP Unit & Case
-
1- Sealed package of tubing
-
1 each- Small/Medium/Large Face pieces
-
1 E Cylinder with C-PAP connection
-
PSI of E-Cylinder
-
OLD C-PAP TAG NUMBER
-
NEW C-PAP TAG NUMBER
Glucometer Check
-
Minimum of 5 Lancets
-
5 Alcohol Wipes
-
Minimum 10 Glucometer Strips
Portable Suction
-
Suction working properly
-
Charged Batteries
-
Any Damage?
Crew Signatures
-
Add signature
-
Add signature