FEEDBACK

PATIENT INFORMATION

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Name of the Patient *

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Email Id *

Visit Date *

Room Number (If you are an in-patient)

FEEDBACK SURVEY

Reception (Guidance & Response to queries)

Treatment by Physicians / Consultants

Pharmacy

Nursing Staff Care (Attitude & Promptness)

Billing (Response to queries & Promptness)

Cleaning & Hygiene

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Name of Staff

Any Other Remarks

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Please rate your experience at Supreme Specialty Hospitals *

4.2/5 - (96 votes)