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18 Cards in this Set

  • Front
  • Back
Preparation and Submission of Dental Equipment and Facilities Report, NAVMED 6750/4
Date format?
D Month YYYY: i.e: 1 January 2007
Unit Identification Code
Name of ship, or Hull number, or Station and building number, and mailing address
I: First Column
Space description
I: Second Column
Quantity, enter total number of spaces
I: Third Column
Approx size, length and width in feet, rounded to nearest foot
I: Fourth Column
Remarks, enter significant information continue to part IV if insufficient space
Dental Treatment Rooms contain
Dental light, chair, unit, and/or surgical table
Part I, II, III, and IV
I) Dental Facility Spaces
II) Dental Equipment
III) Utilities
IV) Remarks and Recommendations
II: First Column
Item Description
II: Second Column
Manufacturer and Model (enter manufacturer name and model number)
II: Third Column
Quantity of items on hand, include installed and in storage
II: Fourth Column
Condition code, enter number of items by cat. and condition code
Part II section A
Dental Operating Equipment
Part II section B
Prosthetic Lab Equipment
Part II section C
Dental X-Ray Equipment
1) Type of current: AC/DC
a) voltage - 120/240
b) cycle - 60
2) Gas: Natural, Commercial, Bottle, Acetylene