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11540 - October 3, 2024 -

Date

October 3, 2024

Repair Order

11540

Facility

Facility Name

BSA

Contact Name

Brian Carlton

Billing Name

BSA Hospital

Email Address

brian.carlton@bsahs.org

Phone Number

Shipping Address

1600 Wallace Blvd

Amarillo, TX 79106

United States

Billing Address

Equipment

PO #

Manufacturer

Philips

Model #

M4841A

Serial #

214387

Asset Tag #

214387

Reported Failure

Broken ECG prong

Anything Else