Fix/Service Request Form Applicant : Tel : Address : Device code : Device : Location : Application Type : Emergency RepairPlanned MaintenanceJob Order Device Status : ActiveInactivethe device is going to become inactive Work Priority : ImmediatelyWithin 24 hoursin suitable timein the free time of the device Request Details : Request Reason : Defect Appearance Signs : Requested Human Resource (Number & Proficiency) : Requested pieces & Material: (list & amount) : Send