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Functional Testing for Patient Information
ISO FRM 4.4.6, Rev 3, 08/07/2014
<table>
<tr>
<th>Software Version</th>
<td width="200"> </td>
<th>Software Build</th>
<td width="100"> </td>
<th>Software Module</th>
<td width="100"> </td>
</tr>
<tr>
<th>Tester</th>
<td> </td>
<th>Test Type</th>
<td colspan="3">
<input type="checkbox"/>Limited
<input type="checkbox"/>Acceptance
</td>
</tr>
<tr>
<th>Processor</th>
<td> </td>
<th>Operating System</th>
<td colspan="3">
<input type="checkbox"/>winXP
<input type="checkbox"/>winVista
<input type="checkbox"/>win7
<input type="checkbox"/>win8
<input type="checkbox"/>Other
</td>
</tr>
<tr>
<th>Physical Memory</th>
<td> </td>
<th>Comments</th>
<td colspan="3"> </td>
</tr>
</table>
<table>
<tr>
<th width="100">Date</th>
<th width="300">Features</th>
<th width="100">Results</th>
<th width="200">Comments</th>
</tr>
<tr>
<td> </td>
<td colspan="3"><b>Allow users to add, modify and delete:</b></td>
</tr>
<tr>
<td> </td>
<td>a. Patient Personal Information.</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td>b. Patient Audiometric Information.</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td colspan="3"><b>Allow users to query patient’s fitting information based on:</b></td>
</tr>
<tr>
<td> </td>
<td>a. Date</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td>b. Circuit/Model</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td>c. Programming Mode</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td colspan="3"><b>Other:</b></td>
</tr>
<tr>
<td> </td>
<td>Generate fitting and session notes reports based on information saved during fitting/programming.</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td>Perform ezFIT conformance test sequence 1 (Application Installation).</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td>Perform NOAH 4 conformance test sequence 3.1 (Installation), if Noah related functionality was updated/fixed.</td>
<td> </td>
<td> </td>
</tr>
</table>
Sign-off
<table width="100%" border="1" cellpadding="1" cellspacing="0" class="inline">
<tr valign="top">
<th colspan="2">The application has successfully passed the above test sequences. The supporting log files and/or manual test worksheets have been included.</th>
</tr>
<tr valign="top">
<td width="70%">Signature<br />(It is acceptable to type in the name and date if the report is being sent electronically)</td>
<td width="30%"> </td>
</tr>
<tr valign="top">
<td>Date</td>
<td> </td>
</tr>
</table>