Adverse Drug Effect_Contact Us

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Contact number:

400 007 5658

Adverse reaction report

24 hour hotline：400-007-5658

Patient Name*

Accept/Reject follow-up*

Yes

Gender*

Male

Female

Age

Reporter Name*

Reporter PhoneNumber*

Approval Number

Reason for medication use

Adverse Reactions*

Drug Name*

Description of Adverse Reaction Process*

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