Merz Adverse Event

Merz Adverse Event

I. EVENT INFORMATION

3. Sex *
Indicate All Propriate To Adverse Event *
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II. SUSPECT DRUG(S) INFORMATION

Det her er en beskrivelse på et felt
20. Did Reaction Abate After Stopping Drug? *
21. Did Reaction Reappear After Reintroduction? *

III. CONCOMITANT DRUG(S) AND HISTORY

*Exclude those used to treat reaction

IV. MANUFACTURER INFORMATION

25a. Report Type
25b. Report Source