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Activate Spare Equipment

This form is to be used when activating spare equipment.


Name of person logging this transfer*


Patient MRN No.*


Asset No.
OFM

( The asset number for equipment can be found located on the O’Flynn Medical label as ‘Rental Number: OFMXXXX’.
This can be most likely found on the pump. )


Location*


Date of Transfer*: Year Month Day


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Enter Code*: (Type Text shown on the image above)

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