Vaccination
Use this form to report any AEFI caused by any kind of vaccination in Zanzibar
Reporter Information
Add Patient Information
Adverse Event(s)
Vaccination Information
| # | Name | Batch number | Dosage | Date started | Expire date | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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Diluent (if applicable)
| # | Name of Diluent | Batch / Lot Number | Date of reconstitution | Expire date | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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No Content Added! | ||||||||||||||