20 CAR § 43-108
(a)
(b)
(d)
(2) The report must:
(i) Physician performing the abortion; or
(ii) Patient on whom the abortion was performed; and
(C) Include:
(b) (b) The type of abortion that caused or may have caused the abortion complication;
(c) (c) The gestational age of the fetus at the time the abortion was performed;
(h) (h) The patient’s:
(5) (5) County of residence;