| Device Name/ID | Batch/Lot Number | ||
|---|---|---|---|
| Assembly Date | Operator Name/ID |
| Step / Component | Verified | Comments |
|---|---|---|
| Component Inspection | ||
| Cleanliness Check | ||
| Correct Parts Used | ||
| Assembly Sequence Followed | ||
| Torque/Force Applied | ||
| Visual Inspection | ||
| Functional Test | ||
| Labeling & Marking | ||
| Packing |
| Verifier Name/ID | Verification Date | ||
|---|---|---|---|
| Remarks | |||
| Signature | |||