This document appears to be a quality control form from a manufacturing setting. It includes fields to record information such as the department, date, preparer, supervisor, quality check number, sampling step, tool used, notes, takt and cycle times, standards for work in progress and quality, and safety. It also references a job instruction sheet and includes fields for the part number, required quantity, team leader, and part name. The form is intended to standardize and document quality control procedures.

1. Dept.
／Location:
Date:
Prepared
By:
Supervisor:
Quality
Check
#
Step
Sampling
Tool
Note
Time
Takt
Time
Cycle
Time
STD
WIP
Quality
Safety
STD
WIP
Total
Standardized
Work
4:
Job
Instruction
Sheet
（標準作業4:
標準作業指導書）
Job
Instruction
Sheet
Part
#
Required
Quantity:
Team
Leader:
Part
Name
122
Kaizen
Express
付録-1：改善フォーム集
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2. 123
Kaizen
Express
Appendix-1: Forms