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Initial Pregnancy Report Form Celgene Drug Safety & Risk Management: Tel: 030284 4525 Fax: 030284 4511 Email: drugsafetynetherlands celgene.com Please complete this form to report a pregnancy in:
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Open the 20-12 pregnancy report formdocx on your computer using a compatible software, such as Microsoft Word.
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Begin by entering your personal information, including your name, address, and contact details.
04
Fill in the relevant dates and details regarding your pregnancy, such as the estimated date of conception and the expected due date.
05
Provide information about any prenatal or genetic testing that has been conducted during your pregnancy.
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Include details about any medical conditions or complications that you have experienced during this pregnancy.
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Mention any medications or supplements that you are currently taking or have taken during your pregnancy.
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If applicable, mention any hospital or healthcare providers that you have been receiving prenatal care from.
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The 20-12 pregnancy report formdocx is a document used to report pregnancy-related information.
All pregnant individuals are required to file the 20-12 pregnancy report formdocx.
To fill out the 20-12 pregnancy report formdocx, provide information about the pregnancy, such as due date, prenatal care provider, and any complications.
The purpose of the 20-12 pregnancy report formdocx is to track and monitor pregnancies for statistical and healthcare purposes.
Information such as due date, prenatal care provider, any complications, and medical history must be reported on the 20-12 pregnancy report formdocx.
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