Hemodynamic Recorder{Serial/Lot Number}  
Hemodynamic Recorder
Model Number
  Date of Implant
{filled in by server}  
New Reused
Manufacturer

Pressure Parameters
Maximum Expected Sytolic Pressure
(default 60)
Minimum Expected Diastolic Pressure
(default 5)
 
Pacing Threshold at 0.5 MS PW
V   mA
Pacing Impedance at 5V Output
ohms
Sensing R-Wave
- mV
 
High Altitude
Typical Altitude
Low Altitude