TIPO DE ADQUISICION: _____________________________
FECHA DE ENTREGA: _______________________________ EXAMENES REALIZADOS EN EL EQUIPO: _______________________________________ INGENIERO RESPONSABLE: __________________________________________________ TELEFONOS DE CONTACTO: __________________________________________________ DESCRIPCION DEL EQUIPO: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________ REQUERIMIENTOS ESPECIALES DE INSTALACION Y FUNCIONAMIENTO: _______________________________________________________________________________ _______________________________________________________________________________ ___________________________________________________________________ ELEMENTOS RECIBIDOS CON EL EQUIPO: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________ RESPONSABLE EN EL LABORATORIO: __________________________________________ OBSERVACIONES: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ ___________________________________________________________