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Name :		Ward:
Address:
Date of birth:		Phone:
Sex:	Male Female	I come as a:	Patient Relative
My Hospital stay at ACMC & KMRC was because of the following factors:	Satisfactory	Good	Better	Best
The Hospital environment
The Hospital Cleaning / Housekeeping
The Food / Diet is
The Toilet's are
The Service of attending Doctors is
The Service of attending Nurses is
The Hospital Billing is
The Reception / Enquiry service is
The Admission Process is
The Discharge Process is
Overall RATE as
Any Suggestion for us:
Which employees work you like?