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Transfusion Reaction Reporting Form (TRRF) For Blood & Blood Components & Plasma Products (Version-2)
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(A) Patient Information
Hospital Code No.:
Your answer
:Patient Initials*:
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Gender*:
Male
Female
Other:
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Blood Group*:
Your answer
Hospital Admission No.*:
Your answer
Age/Date of Birth*
MM
/
DD
/
YYYY
Primary Diagnosis*:
Your answer
Medical History:
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