Patient Name:*

UHID No:*

Category:*
—Please choose an option—YojnaCash

Phone Number:*

Email:*

Name of Treating Doctor:*

Appointment Assistance (if applicable):
ExcellentVery GoodGoodFairPoor

Billing Services:
ExcellentVery GoodGoodFairPoor

Hospital Cleanliness:
ExcellentVery GoodGoodFairPoor

Hospital Parking Facility:
ExcellentVery GoodGoodFairPoor

Pharmacy Services:
ExcellentVery GoodGoodFairPoor

Interaction with Consultant:
ExcellentVery GoodGoodFairPoor

Canteen services:
ExcellentVery GoodGoodFairPoor

Patient Name:*

UHID No:*

Category:*
—Please choose an option—YojnaCash

Name of Treating Doctor:*

Accommodation:*
—Please choose an option—General WardShared Private WardSemi Private RoomICUCCUCTVS ICUPICUNICUDeluxe RoomSuper Deluxe Room

Phone Number:*

Email:*

Admission Counter Services:
ExcellentVery GoodGoodFairPoor

Visits and Interaction by Consultant Doctor:
ExcellentVery GoodGoodFairPoor

Ward Duty Doctor Services:
ExcellentVery GoodGoodFairPoor

Nursing Services:
ExcellentVery GoodGoodFairPoor

Food, Beverages & Canteen Services:
ExcellentVery GoodGoodFairPoor

Housekeeping & Cleaning Services:
ExcellentVery GoodGoodFairPoor

Billing Services:
ExcellentVery GoodGoodFairPoor

Discharge Process:
ExcellentVery GoodGoodFairPoor

Parking facility:
ExcellentVery GoodGoodFairPoor

Behaviour of security staff:
ExcellentVery GoodGoodFairPoor

How likely is that you would recommend our Hospital to your friends and dear ones, if necessary?
Extremely recommendedLikely recommendedNeutralNot recommendedNot at all recommended

How did you come to know about Kamalnayan Bajaj Hospital? (Initial source of information)
Google SearchFacebook & TwitterOnline Presence (Website)Hospital ReputationConsultant ReputationLocationFriends and Family RecommendationDoctor RecommendationMediclaim Policy / InsuranceOthers