Please take a few minutes to give us feedback about our service by filling in this short Customer Feedback Form. We are conducting this research in order to measure your level of satisfaction with the quality of our service.

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Hospital *

MRN NO *

Patient Name *

Mobile No *

Email

Hygiene and Cleanliness at our hospital *

• Excellent
• Good
• Average
• Poor
• Very Poor

Experience and interaction with our doctors *

• Excellent
• Good
• Average
• Poor
• Very Poor

Courtesy & helpfulness of our staff *

• Excellent
• Good
• Average
• Poor
• Very Poor

Response time taken for Consultation, Investigations & Other services *

• Excellent
• Good
• Average
• Poor
• Very Poor

Would you recommend us to your family and friends *

• Yes
• No

Any Other Feedback ?

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