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Volume 2 - Atomic Energy Regulatory Board

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APPENDIX-8C-II<br />

(Refer section 3.6.3 and 3.13.2.5)<br />

ACCEPTANCE/PERFORMANCE/QUALITY ASSURANCE TEST FOR<br />

DIAGNOSTIC X-RAY UNIT/CATH LAB<br />

A. DETAILS OF THE DIAGNOSTIC X-RAY UNIT<br />

1. Name of the manufacturer :<br />

2. Name and address of the of the :<br />

institution where the unit tested<br />

3. Name(s) of person(s) testing :<br />

the unit<br />

4. Dates and duration of the tests :<br />

5. Model name :<br />

6. No. of X-ray tubes : One/two<br />

7. Maximum rating of the unit :<br />

(a) Potential (kV) :<br />

(b) Current (mA) :<br />

(c) Exposure time (seconds) :<br />

8. Name of the Manufacturer of :<br />

the X-ray Tube<br />

9. Type of Detector : Screen film/CR/Digital/IIT<br />

10. Total filtration : —————— mm of Al<br />

Date:<br />

Tested by:<br />

Signature:<br />

Name:<br />

B. CONGRUENCE OF RADIATION & OPTICAL FIELD<br />

Operating Parameters :<br />

Distance : 100 cm, kV : 60 kV, mAs : 5 ( mA = ————, s = ———— )<br />

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