Clinic Facilisies Form - Page 4
20.
(continued)
Marerial
@ith
Stirzuss
Metal
Yes
C ]
C ]
C ]
Padded
Too
-—
Good
(deseribe each below)
condision
)
Fair but
No
Yes
Wo
C}]
€]
(C7
€]
C ]
C ]
C ]
Cj
C]
€7
(C27
€]
C ]
C ]
C ]
C J
C ]
C)]
C1
(¢C€727
¢]
C ]
{ ]
C ]
C ]
C ]
CJ
C
C)]
¢€]
C ]
C ]
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to
Wood
Regular examination tables(s)
Usable
Unusable
Commencs
DIAGNOSTIC EQUIPMENT
£ thera is none of the particular type of diagnostic aquipment in WORKING
condition, be sure co write in zero (0).
22.
_ss
Number of mercury blood pressure cuffs in working condition.
22.
uuNumber of aneroid blood pressure cuffs in working condition.
23.
_s-:
Number of stethoscopes in worktag condicion.
24.
_ss
Number of otoscopes with specula in working condition.
25.Number of ophthalmoscopes in working condition.
26. — Number of reflex hammers in working condition.
27.
_s«Number of tape measures in working condicion.
28.
Number of infanc scalas in working condition.
29.
Number of adulc scales in working condition.