I2
5
Check List
1. The Meter serial number is:
2. The date and time the problem
3. I tested with both the Check Strip and with the
4. The Normal Control Range listed on the end flap
5. The Code Number being displayed on the Meter
6. Please include the lot number and expiration
25
25
occurred was:
Glucometer Elite
Yes____No____
• The Check Strip result was:
• The Normal Control result was:
of the Test Strip carton is: _______ to _______
is: F- _________
The Code Number on the Code Strip and on the
Test Strip foil packet currently being used is:
F- _________
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 infor-
mation is printed on the bottle.
Lot Number:
Expiration Date:
®
Normal Control:
Test Strips
Glucometer Elite
_________
_________
_________
_________
Control
®
XL