Worksheet Sample

WARNING: This page is about a different car, the 2018 Nissan Maxima. However, it is still accessible from the selected car via links, so may be relevant.

Question sheet
Customer's name	MR/MS	Registration number	Initial year registration	____Year____Month____Day
		Vehicle Type	Chassis No.
Storage date	____Year____Month____Day	Engine	Mileage	km/mile
Symptom		□ Vehicle does not start. (□ R position □ D position □ DS position □ M position)
		□ Upshifting does not occur. □ Downshifting does not occur.
		□ Lock-up malfunction
		□ Shift point is too high. □ Shift point is too low.
		□ Shift shock (□ N □ D □ Lock-up □ R, D, DS and M position)
		□ Slip (□ N □ D □ Lock-up □ R, D, DS and M position)
		□ Noise □ Vibration
		When selector lever position is shifted, shift pattern does not change.
		□ Other (------------------------------------------------------)
First occurrence		□ Recently (as from month ____ of year ____)
Frequency of occurrence		□ Always □ Under certain conditions □ Sometimes (____ time(s)/day)
Climate conditions	Irrelevant
Weather		□ Clear □ Cloud □ Rain □ Snow □ Others _________)
Temperature		□ Hot □ Warm □ Cool □ Cold □ Temperature (Approx. ____°C/°F)
Relative humidity		□ High □ Moderate □ Low
Transaxle condition		□ In cold-start □ During warm-up (approx. ____°C/°F) □ After warm-up □Engine speed: ____ RPM
Road conditions		□ Urban area □ Suburb area □ Highway □ Mountainous road (uphill or downhill)
Operating condition, etc.		Irrelevant □ When engine starts □ During idling □ During driving □ During acceleration □ At constant speed driving □ During deceleration □ During cornering (RH curve or LH curve)
Other conditions