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e-Pertanyaan / Maklum Balas (e-Enquiry/Feedback)
Sila isikan maklumat berikut. Maklumat yang bertanda * wajib diisi.
Pertanyaan / Maklum balas anda akan diproses oleh pentadbiran Hospital Teluk Intan. Sila berhubung dengan pihak hospital untuk maklumat lanjut.
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* Indicates required question
Nama (Name) :
*
Your answer
No. KP (I.C No. ):
*
Your answer
No. Tel (Tel. No) :
*
Your answer
E-mel (E-mail)
Your answer
Pertanyaan / Maklum Balas (Enquiry/Feedback) :
*
Your answer
Sila masukkan nilai (Please enter a valid number) :
*
2 + 2 = ???
Your answer
PENAFIAN
Hospital Teluk Intan tidak akan bertanggungjawab ke atas sebarang kehilangan atau kerosakan yang diakibatkan oleh penggunaan maklumat yang dicapai daripada portal ini.
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