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    Diluxshi Shan
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    The document is a survey from a community health strand in Kandawala, Katana asking patients about their visit to the PMCU clinic. It collects information such as the patient's name, age, occupation, place of residence, number of previous visits, and asks them to rate their satisfaction with the consultation given by the doctor, service and care by staff, waiting time to meet the doctor, and facilities provided on a scale from highly dissatisfied to highly satisfied. It concludes by providing space for additional comments.

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    The document is a survey from a community health strand in Kandawala, Katana asking patients about their visit to the PMCU clinic. It collects information such as the patient's name, age, occupation, place of residence, number of previous visits, and asks them to rate their satisfaction with the consultation given by the doctor, service and care by staff, waiting time to meet the doctor, and facilities provided on a scale from highly dissatisfied to highly satisfied. It concludes by providing space for additional comments.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    9 views2 pages

    Survey

    Uploaded by

    Diluxshi Shan
    The document is a survey from a community health strand in Kandawala, Katana asking patients about their visit to the PMCU clinic. It collects information such as the patient's name, age, occupation, place of residence, number of previous visits, and asks them to rate their satisfaction with the consultation given by the doctor, service and care by staff, waiting time to meet the doctor, and facilities provided on a scale from highly dissatisfied to highly satisfied. It concludes by providing space for additional comments.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    SURVEY – PMCU, KANDAWALA, KATANA.

    Community Health strand----- 29.09.2022

    1. Name of patient: ……………………………………………………………………………………….

    2. Age of patient: ……………………………………………………………………………………....

    3. Occupation: ……………………………………………………………………………………………….

    4. Place of residence: …………………………………………………………………………………….

    5. How many times have you visited the clinic previously? ……………………………

    Highly Dissatisfie Neither Satisfied Highly


    dissatisfied d satisfied satisfied
    nor
    dissatisfied
    1. Consultation given by
    the doctor

    2. Service & care by staff

    3. Waiting time to meet


    the doctor
    4. Facilities provided by
    the institution

    6. Please tick the suitable option:

    7. Any other comments: ………………………………………………………………………………….


    ……………………………………………………………………………………………………………………………….

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