Division PART A Rapid notification for suspected serious adverse reactionsF1

Tissue establishment

EU tissue establishment code (if applicable)

Report identification

Reporting date (year/month/day)

Individual affected (recipient or donor)

Date and place of procurement or human application (year/month/day)

Unique donation identification number

Date of suspected serious adverse reaction (year/month/day)

Type of tissues and cells involved in the suspected serious adverse reaction

Single European Code of tissues or cells involved in the suspected serious adverse reaction (if applicable)

Type of suspected serious adverse reaction(s)