fe time or pisparchi t ‘" 0

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Yes

  No

  N/A

• OD 3

  Yes

  No

  N/A

• Diesel Oty (Ltr.)

• al *

  Yes

  No

  N/A

• L Cp

  Yes

  No

  N/A

• Any leakages Mo

  Yes

  No

  N/A

• PNA Meter On/Off Bre

  Yes

  No

  N/A

• All lights & Indicator

  Yes

  No

  N/A

• Current 0 M / Warranty — Books

  Yes

  No

  N/A

• Form 22 / Eway bill

  Yes

  No

  N/A

Driver Name / men: Labs A ( OHI_ Mode of Transport: (22

• Mo.No. Lic. No