Daily Observation Check-list for Ambulance
Date:
S.No. | Check Point | Status | Remarks | |||||
1 | Condition of Break System | |||||||
2 | Condition of Emergency Siren/Horn | |||||||
3 | Condition of Battery | |||||||
4 | Condition of Head lights & tail lights | |||||||
5 | Condition of Air pressure in the 4 tyres | |||||||
6 | Condition of spare tyre | |||||||
7 | Condition of wipers | |||||||
8 | Condition of Break lights | |||||||
9 | Petrol in tank- Full/Half/Quar | |||||||
10 | Engine Oil | |||||||
11 | Water level in Radiator | |||||||
Daily Trail run details: | ||||||||
Time | Initial Reading | Final Reading | Total KM | Signature of the Driver | ||||
Comments of the Driver after Trail run:
Out Going Trips details: | ||||||
Out time | Initial reading | Purpose | In time | Final reading | Total KM | Signature of the Driver |
Petrol filled status:
Oxygen Cylinder Pressure
First Aid appliances availability
Structure condition
Signature of Security Supervisor: