بِسْمِ اللهِ الرَّحْمٰنِ الرَّحِيْمِ

Abuhurairah Trust

Paople Views

Patient’s Feed Back

Patient Name_________          Age___________________

Sex__________________          MR # ___________________

Date _________________          Phone #___________________

Procedure____________________

Time stayed in Hospital

(Date of admitting)___________ (Date of Discharging)________    

Complaint___________________