Notre préoccupation est la santé et la sécurité des patients

Groupe STIO de pharmacovigilance

STIO QPPV
Mail: [email protected]
Tel.: 0224500837

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Patient Initials *

Prénom

Nom

Date of birth *

Age *

Check report type

Gender *

Male
Female

Country

Date of adverse reaction (copy) *

Check all appropriate to adverse reaction

Involved or prolonged inpatient hospitalization
Involved persistence / significance / disability
Life threatening
Congenital anomaly
Other

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Suspect drug(s) information *

Did reaction diminish after stopping drug?

Yes
No
N/A

Did reaction reappear after re-administration? *

Yes
No
N/A

Health-care provider

Pharmacist
Physician
Patient
Other

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Single Line Text (copy)

Numbers

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Date of this report

Report type *

Initial
Follow up

Your Email *

Subject *

STIO is an Egyptian family-owned Private Joint Stock company established in 2016 with an authorized capital of EGP 500 million and a paid-in capital of EGP 100 million

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33 Nazih Khalifa, Heliopolis , Cairo, Egypt

0224500837

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Notre préoccupation est la santé et la sécurité des patients

Groupe STIO de pharmacovigilance

STIO QPPVMail: [email protected]Tel.: 0224500837

STIO QPPV
Mail: [email protected]
Tel.: 0224500837