Anda di halaman 1dari 3

RUMAH SAKIT MATA PADANG EYE CENTER (RSMPEC)

Ramah, Empati, Siaga, Proaktif, Exsclusive, dan Competence

FORM KELUHAN,SARAN DAN KRITIKAN PASIEN


RS MATA PADANG EYE CENTER

Nama (Mohon diisi Lengkap) :


Hari/Tgl :
Jam :
No Tlp yang bisa di hubungi :

Keluhan,Saran dan Kritikan


........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
.........................................................................................................................

Alamat : Jl. Pemuda No. 53, Telp. 0751-30094 (Hunting), Fax. 0751-30098, Padang, Sumatera Barat

RUMAH SAKIT MATA PADANG EYE CENTER (RSMPEC)


Ramah, Empati, Siaga, Proaktif, Exsclusive, dan Competence

FORM KELUHAN,SARAN DAN KRITIKAN PASIEN


RS MATA PADANG EYE CENTER

Nama (Mohon diisi Lengkap) :


Hari/Tgl :
Jam :
No Tlp yang bisa di hubungi :

Keluhan,Saran dan Kritikan


.......................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
.........................................................................................................................

Alamat : Jl. Pemuda No. 53, Telp. 0751-30094 (Hunting), Fax. 0751-30098, Padang, Sumatera Barat

Anda mungkin juga menyukai