Welcome to KILEN Consumer Data base Reports concerning effects/side-effects of medicines
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Sex
Man Women
Hometown and country
Age
Report submitted by
User Relative Doctor Other
Medicine
Medicine prescribed for following illness/condition
Dose
Start date
Stop date
Effect 1
During After During de-escalation
Effect 2
Effect 3
Other medicines currently being taken
Other illnesses/conditions than that mentioned above
How has the effect influenced your regular working day
Very serious Rather serious A little Not at all
How has the effect influenced You
Your own story
Name
Address
Telephone
Telefax