1. You need to follow the format of your Company procedure to be in compliant with your Quality management System.
2. If you don't have - then you can look into that particular Country's regulatory authority website for any prescribed format.
3. If not, then come out with a procedure to include the format of the reporting forms, in line with
MEDDEV Guidance docs, provided if you are satisfied with that or else modify to your company needs and then use that format to report the incidents.
Hope this helps!
Regards,
Sreenu