Formulaire De Rapportage Des Defaults - F Care Systems EVRF Manuel

Générateur de radiofréquence de 4 mhz qui offre la possibilité de traiter différents types de varices
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MANUEL
THERMOCOAGULATION – EVRF

8 Formulaire de rapportage des defaults

This card must be returned to F care systems within 15 days after occurrence of a
problem with the EVRF
F care systems NV
Oosterveldlaan 99
B-2610 –WILRIJK-ANTWERP - Belgium
Fax: +32 3 451 51 39
Email:
Info@fcaresystems.com
I, undersigned (name and function)............................................................ state that, when
using EVRF N° :
.. , on date
. to have experienced the
following problem with the EVRF:
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
NAME and SIGNATURE
STAMP
Telephone number:
......................................................................................................
Email:
......................................................................................................
Date 27/07/2015
Page 52 de 52
N° de révision : 14

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