System information

Regulatory Notices
E-2 Vicon MX Hardware System Reference
Adverse Event Report (21 CFR 803.32)
Note for Completion: Use blank pages if required
Section A. Patient Data
Important
Patient confidentiality to be maintained unless authorized otherwise in writing
by User Facility.
Parameter Function
Patient Years, Months
Patient Gender Male/Female (delete not
applicable)
Patient Weight Kg
MXhardware_Reference.book Page 2 Thursday, September 7, 2006 11:36 AM