BORANG TEMPAHAN (ORDER FORM)
OAE OTOREAD SCREENER
a device that reads and interprets otoacoustic emissions for hearing assessment purposes.

RM106.00 sehari/per day (UKM/Agensi Kerajaan)
RM160.00 sehari/ per day (Swasta)

Pegawai Untuk Dihubungi:
Puan Murhaini Muid
haini269@ukm.edu.my
03-92895039
Sign in to Google to save your progress. Learn more
Email *
Nama Penuh (Full Name) *
Nama Organisasi/Syarikat (Organization Name/Company Name)
Nombor Telefon (Telephone Number) *
Nyatakan Jenis Ujian (Type of Testing) *
Tarikh Dijangka Guna (Expected Usage Date)
MM
/
DD
/
YYYY
Kaedah Bayaran (Method of Payment) *
Kolaborasi Kajian Bersama FSK - Nyatakan Kod Projek Penyelidikan, jika ada
(FSK Research Collaboration - Please State Project Research Code, if any)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Universiti Kebangsaan Malaysia. Report Abuse