| Hearing instrument |
| |
LEFT |
|
| RIGHT |
|
| Model |
|
|
|
| |
|
| Serial number |
|
|
| Battery |
|
□ yes □ no |
| □ yes □ no | |
□ yes □ no |
| Push button | □ yes □ no |
|
| Signal tones |
|
|
|
|
|
□ on □ off |
| Program change | □ on □ off |
□ on □ off |
| Low battery warning | □ on □ off |
□ on □ off |
| Volume control limit | □ on □ off |
□ on □ off |
| volume control change | □ on □ off |
Program |
| Description of the program | |
1 |
|
|
|
|
|
|
|
2 |
|
|
|
|
|
|
|
3 |
|
|
|
|
|
|
|
4 |
|
|
|
|
|
|
|
5 |
|
|
|
|
|
| |
|
| Remote control | |
|
|
|
|
Model |
|
|
|
|
|
|
|
Serial number |
|
|
|
|
|
|
|
31
