Respon Layanan dan Aduan RSUD Limpung

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Respon Layanan dan Aduan RSUD Limpung

Sign in to Google to save your progress. Learn more

* Indicates required question

Jenis respon *

Kesan

Kritik

Saran

Aduan

Nama *

Your answer

No HP *

Your answer

Unit yang Dituju
*

(Contoh: Poli Anak, Poli Kandungan, Ruang Seroja, IGD atau unit lainnya)

Your answer

Apakah anda puas dengan pelayanan kami *

Sangat puas

Puas

Kurang puas

Tidak puas

Kesan/Kritik/Saran/Aduan *

Your answer

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy