by Gomechanics
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Age Concomitant Drugs and Dates of Administration Country DOB Daily Dose Date Received by Manufacturer Date of this Report Did Reaction Abate Did Reaction Reappear Indication For Use Initials MFR Control Number Name and Address of Reporter Name and Addresss of Manufacturer Other Relevant History Reaction Onset Reactions Remarks Report Source Report Type
by college
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by college
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