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  • Patient Name*
  • Your Name
  • EMail*
  • Phone No*
  • Address
P - POOR, A - AVERAGE, G- GOOD, E - EXCELLENT
Reception / Registration
How long did you wait before a staff attended you?
Less than 10 mins
10 - 30 mins
More than 30 mins
Reception
1- P
2 - A
3 -G
4 -E
OPD Services / Staff
1- P
2 - A
3 -G
4 -E
Doctors
1- P
2 - A
3 -G
4 -E
Billing
1- P
2 - A
3 -G
4 -E
Your Comments Here
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