Non Serious Adverse Drug Reactions Report |
| Start Date:2014-10-30 End Date:2014-11-02 |
| Study :EMR200583-500 | Investigator :NA | Country of Investigator : | SiteNo:014 |
| Subject No :014 0001 | Subject Initials :xx | DOB : | Sex:Male | Race: | Height:170cm | Weight:72kg |
| First administration date of batch : | Batch number : |
| Study Drug | Start Date | Dose | Change in Dose |
| Bisoprolol | 09/04/2014 | 5mg | |
| ASA | 09/04/2014 | 75mg | |
| Adverse Event | Start Date | End Date | Time related to study treatment | Causality to study drug | Severity |
| | | | | |
| Causality Factors | Action Taken with Study Treatment | Other action taken | Outcome | AE Special Interest | AE dose limiting toxicity |
| | | | | |
| Event description: |
| Subject received concomitant medications:No |
| Does the subject have any relevant past or present medical conditions: |
| Condition | Start Date | Related to study condition | Ongoing |
| Cardiovascular Diseases(hypertension, ) | | | |
| Diabetes mellitus type 2(type 2) | | | |
| |