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12 Service
26
Check List
1. The Meter serial number is: ___________________
2. The date and time the problem
occurred was: ___________________
3. I tested with both the Check Strip and with the Ascensia
E
LITE
™ Normal Control: Yes____No____
• The Check Strip result was: ___________________
• The Normal Control result was: ___________________
4. The Normal Control Range listed on the end flap of the Test
Strip carton is: _______ to _______
5. The Code Number being displayed on the Meter is:
F- _________
The Code Number on the Code Strip and on the Test Strip foil
packet currently being used is: F- _________
6. Please include the lot number and expiration date of the Test
Strips and Controls currently being used. For the Test Strips,
this information is printed on the carton as well as on the
back of each foil packet. For the Controls, this information is
printed on the bottle.
Lot Number:
Expiration Date:
Test Strips Control