Suggestion & Complaint Form

Full Name:	*
Country:	*
City:
Email:
Tel/Mobile:
When would you like to be contacted?
How should we contact you?	Email      Phone/ Mobile
Your Points of view:	*
Upload your document:
Which services do you want to mention?	Admission & Discharge   Guards   Nursing service   Managment Insurance   Eco/Patalogy   Physicain   Operating room   Other
To whom it may refer:	International Patient Department (VIP Reception) Nursing Matron General Manager
Sequrity Code:	*