Safety Reporting Form

Please see below four ways in which you can report an adverse experience with a specific Ferozsons Laboratories Limited product:

1. You can contact us via phone during office hours and out of office hours on (+92 42) 36026700
2. You can fax any documentation to (+92 42) 36026701-2
3. You can send an e-mail to pharmacovigilance@ferozsons-labs.com
4. You can fill in the form






Patient Information
MaleFemale
Suspected Drug Details
Manufacturer/Marketer (In case of imported products): Ferozsons Laboratories Limited
Adverse Event Details

Seriousness
Life threatening (immediate risk of death due to an event)Initial / prolonged hospitalizationCongenital anomaly / birth defectsPersistent / significant disabilityMedically significant (important medical events that may jeopardize the patient and may require medical / surgical intervention to prevent the other outcome)Non Serious

Outcome
Not resolvedResolvedResolved with sequelaeResolvingUnknownDeath

Pregnancy Exposure

Reporter Information

    Pharma Factory

    P.O.Ferozsons, Amangarh - Nowshera
    (Khyber Pakhtunkhwa)
    +92-923-614295, 610159
    +92-923-611302
    info@ferozsons-labs.com

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