- 3/18/19 - 1 form, 15 itemgroups, 76 items, 1 language
Itemgroups: Administrative,Demographics,Laboratory Tests,Follow-Up Studies,Investigator Signature,Serious Adverse Events,SAE - Study Vaccine Information (13),SAE - Concomitant medication / vaccination that could have contributed to this SAE (14),SAE - Relevant intercurrent illness & medical history that could have contributed to this SAE (15),Drug(s) used to treat this SAE (16),Surgical treatment for this SAE (17),Description (18),SAE - Comments,Tracking Document,Investigator signature

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