Adverse Reaction Reporting
Please fill in the fields as accurately as possible. If there are fields you cannot fill in, please write "unknown". Fields marked with an asterisk must be filled in.
Please use the date format DD-MMM-YYYY (Example 25-FEB-2023). If you do not know the exact date, please enter the closest possible date.
If you have further relevant information, please use the field "Additional information".
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