For reporting of adverse events/side effects and/or product quality complaints

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FAQ

Session Idle:    seconds

Status: New

Unique Id: UID38020430546202407

Reporter's Information


Health care professional Patient Others
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Patient's Information

Female Male

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Age (years) *

Suspect Product Information

Select the brand name of the Biocon Biologics product which the patient has used. If Brand name is not available in the dropdown list or with the patient, select "Others" and mention Generic name of the medicine.


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RadDatePicker
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RadDatePicker
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cn

Event Information


Adverse Event/Side effect Product problem others

Event Onset Date
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What is the outcome of the event condition

Recovered/Resolved Not recovered/Not resolved Recovering/Resolving
Recovered/Resolved with sequelae Unknown Death/Fatal

Yes No