Frontier Lifeline Hospital
Out Patient Feed Back Form
Email *
Hospital (UHID) No :118845 *
Patient Name *
Mobile No *
Reception / Registration Services
How long did you wait before a staff attended you *
RECEPTION *
Poor
Average
Good
Excellent
Helpful & Courteous
Registration Procedure
Explained clearly Hospital Policies
OPD SERVICES / STAFF *
Poor
Average
Good
Excellent
History taking
Helpful & Courteous
Attentive & Available
How long did you wait in Out Patient Department (OPD) *
How long did you wait in Billing Department *
How long did you wait in Blood Collection *
How long did you wait in X-Ray Department *
How long did you wait in ECG Department *
How long did you wait in ECHO Department *
Pharmacy Department *
Poor
Average
Good
Excellent
Has the Intake of Medicines clearly explained
Has the Dosage of Medicines clearly explained
Other Department Services
Poor
Average
Good
Excellent
None
X-Ray
ECG
ECHO
TMT
Laboratory Services
Patient reports Given on Time
Pharmacy
Nutrition / Diabetic Advice
DOCTORS Services *
Poor
Average
Good
Excellent
Helpful & Courteous
Availability
Services Rendered
Procedures Explained
Other Services *
Poor
Average
Good
Excellent
None
Coffee Shop / Food & Beverages Drinking water
Security
Comments / Suggestions
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