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Ambulance Checklist

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Ambulance Checklist

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AAROGYA HOSPITAL, RAIPUR, CHATTISGARH

AMBULANCE CHECKLIST

Month & Year

Checks 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Water in Oxygen Humidifier
Oxygen Cylinder Key
Life Saver-Face Mask
First Aid Box
Movement of stretcher
Internal/External Cleanliness
Siren
Horn
Air pressure in tyre
Coolant level in Radiator
Rear view Mirror
Centre Mirror
Breaks
Break Lights
Parking Light
Reverse Light
Head Lamp
Light in the patient room
Stepny Tyre
Wheel Spanner
Water Wash Monday Thursday Monday Thursday Monday Thursday Monday Thursday

Driver
Sign
Facility
Supervisor

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