Patient Care Feedback Form Choose Language EnglishMarathi Patient Feedback To provide satisfactory and excellent facilities in the hospital, we need your suggestions and feedback. Name of Patient Age Gender MaleFemale Address Contact No. Registration No. Your Email How do you rate the Information Given at Information Centre? ExcellentGoodAveragePoorBad How do you rate your receival as a patient by oral health care providers during your first visit? ExcellentGoodAveragePoorBad How do you rate the hospital environment? ExcellentGoodAveragePoorBad How do you rate the hospital administrative services? ExcellentGoodAveragePoorBad How do you rate the overall cleanliness of the hospital and the facilities provided ExcellentGoodAveragePoorBad How do you rate your experience during a subsequent visit to the institution ExcellentGoodAveragePoorBad How do you rate the treatment services provided at the hospital? ExcellentGoodAveragePoorBad How do you rate the emergency treatment services at the hospital? ExcellentGoodAveragePoorBad How do you rate the Treatment Charges at this Hospital? ExcellentGoodAveragePoorBad What is your overall opinion about the hospital? ExcellentGoodAveragePoorBad Click here to fill the form