维修单位:_______________ 联系电话:_____________

    地址:___________________ 邮编:_________________

    送修故障:_______________________________________

    修理结果:_______________________________________

    日期: __________________ 经手人:_______________

    送修故障:_______________________________________

    修理结果:_______________________________________

    日期:___________________ 经手人:_______________

    送修故障:_______________________________________

    修理结果:________________________________________

    日期:___________________ 经手人:________________