User's Manual

Case Form Report
A- 4
Trial ID : Version No. : 1.0 :
30/07/2007
Screening
Subject No.: Subject Initials : Center No.:
Date of Informed consent signed
DMMYYYY
Inclusion Criteria
Yes No N/A
1. Informed consent form voluntarily signed
2. Male / Female subject of age 19 years~70 years.
If there is one or more mark of ‘No’, you shall be contradicted for this clinical test.
CONFIDENTIAL