subject_line
Rechargeable Flashlight Check
Equipment Number
*
Year
*
2016
2017
2018
2019
2020
2021
2022
2023
Month
*
January
February
March
April
May
June
July
August
September
October
November
December
Instrument Working Properly?
*
Yes
No
If Not, Action Taken?
*
Notes
*
Date Check Performed
*
+
Signature of Individual Performing Check
*
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