implant card
Instruction for completion
- Name of the patient or patient ID. To be filled by healthcare institution/provider.
- Date of Implantation. To be filled by healthcare institution/provider.
- Name and Address of the healthcare institution/provider. To be filled by healthcare institution/provider.
- Manufacturer’s information website.
- Device type in the required language.
- Device Name.
- LOT Number.
- Expiration Date.
- Name and Address of the manufacturer of the implanted medical device.
Explanation/Translation of symbols
Patient Name or Patient ID
Name and Address of the implanting healthcare institution
Date of Implantation
Device Name
Manufacturer
Information Website for Patients
LOT Number
Expiration Date