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Opção 1
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Data da ocorrência do Evento Adverso
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DD
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YYYY
Setor da Ocorrência
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Nome completo do(a) paciente
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Matrícula do paciente
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Data de Nascimento
MM
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DD
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YYYY
Data da internação
MM
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DD
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YYYY
Detalhamento do evento
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Ação imediata do setor responsável
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