Patient Care Feedback Form

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    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?
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    How do you rate your receival as a patient by oral health care providers during your first visit?
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    How do you rate the hospital environment?
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    How do you rate the hospital administrative services?
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    How do you rate the overall cleanliness of the hospital and the facilities provided
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    How do you rate your experience during a subsequent visit to the institution
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    How do you rate the treatment services provided at the hospital?
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    How do you rate the emergency treatment services at the hospital?
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    How do you rate the Treatment Charges at this Hospital?
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    What is your overall opinion about the hospital?
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