Section 1 of 1
SISTEM ADUAN DAN PELAYANAN ASPIRASI DINAS KESEHATAN KOTA DENPASAR
Silahkan isikan formulir dibawah terkait dengan layanan pengaduan pelayanan Dinas Kesehatan Kota Denpasar
Email
Email
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Nama
Nama
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Umur
Umur
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Pendidikan
Pendidikan
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Pekerjaan
Pekerjaan
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Alamat
Alamat
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Nomer Whatsapp
Nomer Whatsapp
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Tanggal Kejadian
Tanggal Kejadian
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Lokasi Pelayanan
Lokasi Pelayanan
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Jenis Pengaduan
Jenis Pengaduan
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Date
Time
Sikap atau Perilaku Staf
Keterlambatan Pelayanan
Informasi Pelayanan Tidak Jelas
Sarana Dan Prasarana
Administrasi Pelayanan
Sistem Pelayanan
Dugaan Pungutan Liar
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Jelaskan secara singkat kronologi atau permasalahan yang dialami
Jelaskan secara singkat kronologi atau permasalahan yang dialami
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Apakah Anda Bersedia Menggunakan Kembali Layanan Dinas Kesehatan Kota Denpasar Apabila Diperlukan ?
Apakah Anda Bersedia Menggunakan Kembali Layanan Dinas Kesehatan Kota Denpasar Apabila Diperlukan ?
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Apa Yang Perlu Kami Tingkatkan Agar Pelayanan Lebih Baik ?
Apa Yang Perlu Kami Tingkatkan Agar Pelayanan Lebih Baik ?
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Harapan atau Penyelesain Yang Diinginkan
Harapan atau Penyelesain Yang Diinginkan
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Lampirkan Layanan Diadukan
Lampirkan Layanan Diadukan
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Paragraph
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Persetujuan
Persetujuan
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Saya menyatakan bahwa informasi yang saya sampaikan adalah benar
Saya Bersedia dihubungi apabila diperlukan informasi tambahan
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