Preventive Maintenance Report Form
Station Information
Station ID
Station Name
Type of Station
Planned PM Date
Actual PM Date
Difference (Actual vs Planned)
1. Team Members & Actions
1.1 Team Members
Team Members 1
Position 1
Remark 1
Upload Team Picture 1
Team Members 2
Position 2
Remark 2
Upload Team Picture 2
1.2 Cleaning Actions:
Cleaning Actions 1
Cleaning Actions 2
Cleaning Actions 3
Cleaning Actions 4
2. Station Pictures
2.1 Station Pictures
Picture of Front View:
Picture of Inside View
3. Back Office Equipment
3.1 CPU:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.2 LCD Monitor:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.3 Keyboard:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.4 Mouse:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.5 Printer Laser:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.6 Switch Hub:
Picture_of_Before_Maintenance:
Remark
Picture_of_After_Maintenance:
Remark
Picture_of_Serial_Number:
Remark
3.7 Electrical Plug 8 Sockets (ELCB):
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.8 UPS:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.9 Surge Guard:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
3.10 FDM:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4. POS Equipment
4.1 POS:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4.2 Keyboard:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4.3 Mouse:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4.4 Printer Thermal:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4.5 Cash Drawer:
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
4.6 Electrical Plug 6 Sockets (ELCB):
Picture of Before Maintenance:
Picture of After Maintenance:
Picture of Serial Number:
5. Additional Notes
Problems Found:
Detail Problem:
Picture of Problems Found
Picture of Problems Found
Solutions Implemented:
Detail Solutions Implemented:
Picture of Solutions Implemented: (multiple pictures)
Picture of Solutions Implemented: (multiple pictures)
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