I agree to participate in this research on “Factors associated with Low Birth Weight at the Central Hospitals in Vientiane Capital: A Matched Case- Control Study” as a participant. I agree to give the following details: i) my clinical data, ii) about my life, history and Maternal factors, Health and illness history during pregnancy.
I am giving this consent voluntarily as I have been fully explained about the confidentiality to protect my privacy and the experimental procedure. I understood the potential benefits of the investigation for myself, the hospital and the country. Also, I understood that the data obtained in this study will be used in a manner to maintain confidentiality and personal rights.
Furthermore, I also know that I can withdraw my consent and discontinue the participation at any time without any penalty