PATIENT FEEDBACK FORM

We are grateful to you for giving us the opportunity to serve you. To help us in our Endeavour to serve you better we sincerely request you to kindly give us your opinion and suggestions on the hospital outpatients services by checking the appropriate box. Your identity will remain confidential at all times. We appreciate your feedback and assure you of our best services always. Excellent= 5 Good= 4 Fair= 3 Poor= 2 Unacceptable= 1 * Required