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CONFIDENTIAL SUSPECTED ADVERSE EVENTS Safer Health Products Through Reporting PARTICULARS OF PATIENT Name/initials:ERIC/FIN/Passport no.:Age:heavyweight:Sex:Female:ethnic group:ChineseMaleIndianOutcome:Date
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Gather all necessary personal information such as name, address, social security number.
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Individuals who have a health savings account (HSA) and need to report contributions and withdrawals for tax purposes.

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