精选优质文档-倾情为你奉上制造商向国家主管当局提交报告格式表 ANNEX 3 REPORT FORM FOR MANUFACTURERS TO THE NATIONAL COMPETENT AUTHORITY Report FormManufacturers Incident Report制造商事故报告表医疗器械警戒系统(MEDDEV 2.12/1 rev 8)1 行政信息 Administrative information接收者Recipient国家主管当局名称Name of National Competent Authority(NCA)国家主管当局地址Address of National competent Authority主管当局盖章Stamp box for the Competent Authority (6040 mm)该报告的时间Date of this report制造商指定的参考号码Reference number assign