Get Dd Form 2163
QUIRED TAKEN DATE NEXT SERVICE DUE EQUIPMENT IDENTIFICATION COMPONENTS MANUFACTURER MODEL (Include type, style, size, focal spots, etc.) SERIAL NUMBER (Housing) 1. CONTROL NO. 1 (Master Control) 2. CONTROL NO. 2 (Room Control) 3. RADIOGRAPHIC TUBE 4. RADIOGRAPHIC TUBE (Auxiliary tube) 5. FLUOROSCOPIC TUBE II. VISUAL INSPECTION OF EQUIPMENT ACTION ITEMS FOR VISUAL INSPECTION 6. 7. 8. 9. 10. 11. III. 12. 13. 14. 15. 16. 17. NOT REQUIRED TYPE REQUIRED CERTIFICATION LABELS ARE AFFIXED AND.
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