<!DOCTYPE html>
<html>

<head>
    <meta charset="utf-8">
    <title>Certificate of Instruments TMS50i</title>

    <style>
        @import url('https://fonts.googleapis.com/css2?family=Playfair+Display:ital,wght@0,400..900;1,400..900&display=swap');

        @page {
            margin: 15mm;
        }

        body {
            font-style: italic;
            margin: 0;
            padding: 0;
            color: #000;
            font-size: 13px;
        }

        .container {
            width: 100%;
        }

        .doc-number {
            font-style: normal;
            padding: 0;
            margin: 0;
            text-align: right;
            font-size: 12px;
        }

        .title {
            margin: 30px 0px;
            text-align: center;
            font-style: italic;
            text-decoration: underline;
            font-size: 20px;
        }

        h4 {
            margin: 1px 0;
            padding: 0;
            font-size: 13px;
        }

        .customer-table {
            width: 100%;
            border-collapse: collapse;
        }

        .customer-table td {
            padding: 1px 0;
            vertical-align: top;
        }

        .customer-table td.label {
            width: 180px;
        }

        .box {
            border: 1px solid #000;
            padding: 10px;
            margin-top: 10px;
        }

        .box h4 {
            margin: 0;
        }

        .result-table {
            width: 100%;
            border-collapse: collapse;
            margin-top: 10px;
            font-size: 13px;
        }

        .result-table th,
        .result-table td {
            border: 1px solid #000000;
            padding: 1px 6px;
            text-align: center;
        }

        .conclusion {
            margin-top: 15px;
        }

        .footer {
            margin-top: 20px;
            width: 250px;
        }

        .date {
            margin-bottom: 70px;
            font-style: italic;
        }


        .detail-table {
            width: 100%;
            border-collapse: collapse;
        }
        .detail-table td {
            padding: 0;
            vertical-align: top;
        }
        .detail-table td.label {
            width: 180px;
        }


        .name {

            font-style: italic;
            border-bottom: 1px solid #000;
            display: inline-block;
            width: 80%;
            padding-bottom: 2px;
        }

        .position {
            margin-top: 5px;
            font-style: italic;
        }

        .clearfix::after {
            content: "";
            clear: both;
            display: table;
        }
    </style>
</head>

<body>
    <div class="container">

        <div class="doc-number">
            Nomor: FO.III.12/04.00/2019
        </div>

        <div class="title">
            <h3>Certificate of Instrument Calibration</h3>
        </div>

        <div class="section">
            <table class="customer-table">
                <tr>
                    <td class="label">
                        <h4>Customer Data</h4>
                    </td>
                    <td></td>
                </tr>
                <tr>
                    <td class="label">
                        Laboratory / Hospital
                    </td>
                    <td>
                        : Trisensa Diagnostic Center
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        Address
                    </td>
                    <td>
                        : Jl. Taman AIS Yasin No.5, Embong Kaliasin, Kec. Genteng, Surabaya 60271
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        Instrument
                    </td>
                    <td>
                        : Clinical Chemistry Analyzer TMS 50i Superior
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        Serial Number
                    </td>
                    <td>
                        : 5303150816
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        Date of Calibration
                    </td>
                    <td>
                        : January 09, 2026
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        Valid Until
                    </td>
                    <td>
                        : January 09, 2027
                    </td>
                </tr>
            </table>

        </div>

        <div class="box">

            <table class="detail-table">
                <tr>
                    <td class="label">
                        <h4>Required Material</h4>
                    </td>
                    <td>SC Cal</td>
                </tr>
                <tr>
                    <td class="label">
                        <h4>Procedure</h4>
                    </td>
                    <td>
                        Checking Instrument Status, Running Callibartion
                    </td>
                </tr>
                <tr>
                    <td class="label">
                        <h4>Requirement</h4>
                    </td>
                    <td>
                        Deviation must be ≤ 2.0% ; 3 Impedance measurement must be OK; Measurement point must be within range
                    </td>
                </tr>
            </table>

            <h4>Results</h4>

            <table width="100%" cellspacing="0" cellpadding="0">
                <tr>
                    <td width="50%" style="vertical-align:top; padding-right:10px;">
                        <h4>Calibration Factor</h4>
                        <table class="result-table">
                            <tr>
                                <th>Parameters</th>
                                <th>Reference</th>
                                <th>Value</th>
                                <th>Result</th>
                            </tr>
                            <tr>
                                <td style="text-align:left;">WBC</td>
                                <td>75 - 125</td>
                                <td>95.20</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RBC</td>
                                <td>75 - 125</td>
                                <td>105.38</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">HGB</td>
                                <td>75 - 125</td>
                                <td>101.86</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">MCV</td>
                                <td>75 - 125</td>
                                <td>104.22</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">PCT</td>
                                <td>75 - 125</td>
                                <td>105.58</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RBC-O</td>
                                <td>75 - 125</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">PCT-O</td>
                                <td>75 - 125</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">PCT-H</td>
                                <td>75 - 125</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                        </table>
                    </td>


                    <td width="50%" style="vertical-align:top; padding-left:10px;">
                        <h4>Optical</h4>
                        <table class="result-table">
                            <tr>
                                <th>Parameters</th>
                                <th>Deviation</th>
                                <th>Result</th>
                            </tr>
                            <tr>
                                <td style="text-align:left;">DIFF_FS</td>
                                <td>0.1</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">DIFF_SS</td>
                                <td>0.8</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">DIFF_FC</td>
                                <td>0.5</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">DIFF_PMT</td>
                                <td>N/A</td>
                                <td>Pass</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RET_FS</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RET_SS</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RET_FC</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                            <tr>
                                <td style="text-align:left;">RET_PMT</td>
                                <td>-</td>
                                <td>-</td>
                            </tr>
                        </table>
                    </td>
                </tr>
            </table>

            <h4 style="margin-top:20px;">Impedance</h4>
            <table class="result-table">
                <tr>
                    <th>Parameters</th>
                    <th>Target</th>
                    <th>1</th>
                    <th>2</th>
                    <th>3</th>
                    <th>Result</th>
                </tr>
                <tr>
                    <td style="text-align:left;">MCV_G</td>
                    <td>93.1</td>
                    <td>97.9</td>
                    <td>92.7</td>
                    <td>93.3</td>
                    <td>OK</td>
                </tr>
                <tr>
                    <td style="text-align:left;">HGB</td>
                    <td>4.40</td>
                    <td>4.75</td>
                    <td>4.40</td>
                    <td>4.40</td>
                    <td>OK</td>
                </tr>
            </table>

            <h4 style="margin-top:20px;">ESR Measurement Point</h4>
            <table class="result-table">
                <tr>
                    <th>Parameters</th>
                    <th>Tested</th>
                    <th>Reference</th>
                    <th>Result</th>
                </tr>
                <tr>
                    <td style="text-align:left;">Measurement Point (µL)</td>
                    <td>-</td>
                    <td>135 - 180</td>
                    <td>-</td>
                </tr>
            </table>


            <div class="conclusion">
                <h4>Conclusion</h4>
                <h4>Instrument Auto Hematology Analyzer BC-760R has been already calibrated.
                    The result of calibration is good.</h4>
            </div>

        </div>


        <div class="clearfix">
            <div class="footer">
                <div class="date">Jakarta, January 23, 2026</div>
                <div class="name">Adhitya Pranata Putra</div>
                <div class="position">Technical Support Manager</div>
            </div>
        </div>

    </div>
</body>

</html>