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Mammography Tubes Housing

Tubes must be prepaid with a completed Tube Service Report describing the reason for return, operating conditions, Installed and removal dates in order to recieve Warranty consideration.

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* Date:
	* Dealer       * OEM
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* Country:
* Institution: (Where Tube Installed)
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Return Tube Information * X-ray Tube Type: * Serial Number: Dates * Tube Received Ex. MM/DD/YYYY * Tube Installed Ex. MM/DD/YYYY * Tube Removed Ex. MM/DD/YYYY * Reason for removal of service: Manufacturer of Generator: Manufacturer Type: * Type of Circuit Single Phase: Three Phase: Single Phase Cap Smooth: High Frequency: * Number of Exposures:     Techniques at Time of Difficulty * kV * mA * Time Techniques Most Frequently Used * kV * mA * Time Maximum Exposure Techniques Used * Max kV used: * Max mA used: High voltage cables/components replaced monthly?    Yes    No Have there been previous tube failures?    Yes    No    If so, when and for what reason? Replacement Tube Type * Insert Model: * Serial Number: Additional Comments:

    

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