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Out Patient Customer Satisfaction Survey Bangkok Hospital Samui
Effective Date 01.11.23
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Visit Date
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Choose
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Visit Month
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Choose
Jan
Feb
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Apr
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You are
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Patient
Relative
Age
*
Your answer
How many times using our services in the last 12 months.
*
First visit
1 Time
2 Time
more than 2 times
Patient Type
*
Fever , Unwell
Accident
I have been using the service of
*
Choose
Pha-ngan International Hospital
Emergency Service
Surgery Dept.
OPD Check up/ Health Promotion
OPD Medicine
Paediatrics Unit
Dental Unit
OB/Gyn Service
Rehabilitation Service
Hemodialysis Unit
Special medical Units
Hyperbaric Chamber
Beauty and Skin
Other
Your answer
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