Adverse Event

Pharmacovigilance Case: any complaints related to the use of one of our distributed products that result in Adverse Event, Adverse Drug Reaction, special situations include use of product during pregnancy or breast feeding, lack of therapeutic activity, misuse, overdose, un-intended beneficial effect, occupational exposure, etc.

Name

First Name

Last Name

Profession

Email

Phone

Country

(###)

###

####

City and Country

Product Name

Product Information

(Strength and Dosage Form)

Batch Number

Expiry Date

Patient Name

First Name

Last Name

Case Description