1. Instrument & Certificate Details

Certificate ID / PO No.

Instrument Type

Manufacturer

Model Number

Serial Number

Location/Department

2. Calibration Standards & Procedure

Date of Calibration

Next Calibration Due Date

Reference Standard ID

Calibration Procedure

3. Calibration Results Data

Reference Value (Std)

Unit

Measured Value (As Found)

Tolerance (±)

Add Data Point

Results Register

Reference (Std)	Measured (As Found)	Error	Tolerance (±)	Unit	Status	Action
Add calibration data points above.

4. Certification & Compliance

Overall Result Statement Pass - Instrument is within tolerance. Fail - Instrument is outside tolerance.

Calibrated By (Technician)

General Comments (Traceability, Limitations)