Daily Observation Check-list for Ambulance
Date:
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S.No.
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Check Point
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Status
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Remarks
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1
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Condition of Break System
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2
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Condition of Emergency Siren/Horn
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3
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Condition of Battery
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4
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Condition of Head lights & tail lights
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5
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Condition of Air pressure in the 4 tyres
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6
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Condition of spare tyre
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7
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Condition of wipers
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8
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Condition of Break lights
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9
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Petrol in tank- Full/Half/Quar
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10
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Engine Oil
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11
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Water level in Radiator
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Daily Trail run details:
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Time
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Initial Reading
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Final Reading
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Total KM
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Signature of the Driver
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Comments of the Driver after Trail run:
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Out Going Trips details:
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Out time
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Initial reading
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Purpose
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In time
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Final reading
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Total KM
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Signature of the
Driver
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Petrol filled status:
Oxygen Cylinder Pressure
First Aid appliances availability
Structure condition
Signature
of Security Supervisor:
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