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FORMAT OF ADVERSE EVENT REPORTING FORM For office Use only Internal Assessment No Please mail this form to Cadila Pharmaceuticals Limited Corporate Campus Bhat Sarkhej Dholka Road Ahmedabad 382210 Gujarat India. Ph- 91-2718-225001-15 Fax 91-2718-225039 Or Email at Pharmacovigilance cadilapharma.co. Therapy dates Male 4. Height 5. Weight cm kg Female 6. Country B. Adverse Event 7. Seriousness of the event Death Hospitalization- initial or prolonged Congenital anomaly 8. Date of this report...
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01
To fill out the format of adverse event, follow these steps:
02
Start by providing the necessary information about the adverse event such as the date and time it occurred.
03
Clearly state the details of the adverse event, including any signs or symptoms experienced.
04
Describe any actions taken or treatments provided in response to the adverse event.
05
Include information about any healthcare professionals involved and their contact details.
06
Provide any additional relevant information or documentation related to the adverse event.
07
Review the filled-out format for accuracy and completeness before submitting.
08
Submit the filled-out format to the appropriate authority or organization as per the required procedure.
Who needs format of adverse event?
01
The format of adverse event is typically needed by healthcare professionals and organizations involved in monitoring and addressing adverse events.
02
This includes medical practitioners, hospitals, pharmaceutical companies, regulatory bodies, and research institutions.
03
The format helps in documenting, analyzing, and reporting adverse events to ensure patient safety and improve healthcare practices.
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