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Ambulance Maintenance

Ambulance maintenance checklist has to be followed at every month end

Reviewer Name *

Driver Name *

Odometer Reading *

Vehicle Number *

Date of last- Oil change *

Date of last- Air filter change *

Date of last- Oil filter change *

Date of last- Engine Tune-up *

Mileage of last- Oil change *

Mileage of last- Air filter change *

Mileage of last- Tire Rotation *

Mileage of last- Oil filter change *

Mileage of last- Engine Tune-up *

Date & Time of Check *

Interior

Check belts for signs of fray or cracks *

OK
Not OK

Not Ok- Remarks

Mirrors/ Glass Clean/ Clear View *

OK
Not OK

Not Ok- Remarks

Check hoses for leaks or bulges *

OK
Not OK

Not Ok- Remarks

Interior Lights *

OK
Not OK

Not Ok- Remarks

Make heater & air conditioning work *

OK
Not OK

Not Ok- Remarks

Check wipers *

OK
Not OK

Not Ok- Remarks

Brake lights or Tail lights *

OK
Not OK

Not Ok- Remarks

Head lights- High beam & Low beam *

OK
Not OK

Not Ok- Remarks

Windows / Windshield Function or Cracks *

OK
Not OK

Not Ok- Remarks

Turn Signals *

OK
Not OK

Not Ok- Remarks

Horn *

OK
Not OK

Not Ok- Remarks

Door locks *

OK
Not OK

Not Ok- Remarks

First-Aid kit *

OK
Not OK

Not Ok- Remarks

Exteriors

Check engine and ground for signs of leaks *

OK
Not OK

Not Ok- Remarks

Upholstery, loose objects *

OK
Not OK

Not Ok- Remarks

Tires- Tread or Condition *

OK
Not OK

Not Ok- Remarks

Tires- Proper Inflation *

OK
Not OK

Not Ok- Remarks

Battery Cables *

OK
Not OK

Not Ok- Remarks

Spare tire *

OK
Not OK

Not Ok- Remarks

Exhaust system *

OK
Not OK

Not Ok- Remarks

Shock absorbers *

OK
Not OK

Not Ok- Remarks

Fan belt *

OK
Not OK

Not Ok- Remarks

Lubricate chasis *

OK
Not OK

Not Ok- Remarks

Liquid Level Check

Coolant *

OK
Not OK

Not Ok- Remarks

Gear box Oil *

OK
Not OK

Not Ok- Remarks

Oil *

OK
Not OK

Not Ok- Remarks

Auto Transmission *

OK
Not OK

Not Ok- Remarks

Power Steering *

OK
Not OK

Not Ok- Remarks

Brake fluid *

OK
Not OK

Not Ok- Remarks

Window Washer *

OK
Not OK

Not Ok- Remarks

360 degree video of the vehicle *

Drag & Drop Files, Choose Files to Upload You can upload up to 15 files.

Minimum 30 seconds video should be uploaded

Dents / Scratches *

Drag & Drop Files, Choose Files to Upload You can upload up to 15 files.

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