Sabzevar Heshmatie Hospital

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:
 متن درون تصویر را در جعبه متن زیر وارد نمائید 
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