ANNEX ISupplementary provisions
ANNEX I Initial Report for suspected serious adverse events or reactions 1. Reporting Member State 2. Report identification number: country (ISO)/national number 3. Contact details of the reporter (competent authority or delegated body in the reporting Member State): telephone, e-mail and, when available, fax 4. Reporting centre/organisation 5. Contact details of coordinator/contact person (transplant/procurement centre in the reporting Member State): telephone, e-mail and, when available, fax 6. Reporting date and time (yyyy/mm/dd/hh/mm) 7. Member State of origin 8. National donor identification number, as communicated under Article 6 9. All Member States of destination (if known) 10. National recipient identification number(s), as communicated under Article 6 11. Onset date and time of serious adverse event or reaction (yyyy/mm/dd/hh/mm) 12. Detection date and time of serious adverse event or reaction (yyyy/mm/dd/hh/mm) 13. Description of serious adverse event or reaction 14. Immediate measures taken/proposed