№ lp_1_2_50178
Structured medical reporting form for documenting adverse drug reactions and adverse events following immunization, including patient details, event description, suspected product information, and reporter data.
Year: 2022
Revision Number: 02
Revision Date: 25/07/2022
Effective Date: 13/08/2022
Review Due Date: 25/07/2025
Document Number: FDISM/PVSM/FOM/013
Reference Document: FDISM/PVSM/GDL/002
Document Type: Form
Department/Division/Office/Unit: FDISM/PVSM
Target Audience: Healthcare professionals reporting ADRs/AEFIs
Jurisdiction: Rwanda
Price: 8 / 10 USD
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