| PATIENT | REACTANT | GMR ALLERGY | REACTIONS | CHART MARKED | ID BAND MARKED | ORIGINATOR SIGN OFF | MECHANISM | VERIFIED | DRUG INGREDIENTS | VERIFICATION DATE/TIME | VERIFIER | ENTERED IN ERROR | DATE/TIME ENTERED IN ERROR | USER ENTERING IN ERROR | COMMENTS | DRUG CLASSES | ALLERGY TYPE | ORIGINATION DATE/TIME | ORIGINATOR | OBSERVED/HISTORICAL | *REPORTABLE | HISTORICAL SEVERITY | HISTORICAL DATE/TIME OF EVENT |
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