An object of the present invention while suppressing the burden on medical institutions and MR, to provide a report sheet to understand the research status of post-marketing of pharmaceutical products easily and accurately. In A survey status report sheet 10, the title area 12, and the schedule described region 14, are provided and the report for the seal affixed region 16. The schedule described region 14, multiple column describing the evaluation period is I are arranged along the time series. To report for seal pasting area 16, a plurality of reporting seal 20 to 24 that briefly describes the timing and evaluation results evaluation, it is stuck in association with each column of the schedule described region 14. When the dosing evaluation of the patient is carried out, medical institutions to fill out the prescribed matters to report seal 20-24. Report seal 20 to 24, is recovered by MR who visited the medical institution, is sent to the pharmaceutical manufacturer. .BACKGROUND
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