PEMERINTAH KOTA PALOPO

RUMAH SAKIT UMUM DAERAH SAWERIGADING PALOPO

Alamat : Jln. Dr. ratulangi Km. 7 rampoang

Kode Pos : 91914

Telepon: (0471) 33121333

Faks

Email

Website

: rsud.swg@gmail.com

: (0471) 3312144
:

FORMULIRKOMPLAIN(KELUHAN)

NamaPasien/Keluarga
TanggalLahir
Tanggal/JamKomplain
Ruangan/Bagian

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URAIANMASALAH

No
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Masalah:Baru
Lama

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PenerimaKomplain
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TINDAKANPENYELESAIANSAATKEJADIAN:
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EVALUASI/TINDAKLANJUT:
Tidakperlutindaklanjut
Perlutindaklanjut
Evaluasioleh

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