COMPLAINT AND FEEDBACK/SUGGESTION FORM
COMPLAINT AND FEEDBACK/SUGGESTION INFORMATION

FORM CATEGORY
:
Complaint   Feedback/Suggestion
NAME
:
ADDRESS
:
   
   
POSTCODE
:
PHONE NUMBER
:
EMAIL
:
PATIENT IC NUMBER  
PATIENT RN NUMBER  
DETAIL
:

  

-- Any complaints or suggestions can also be made via e-mail at aduan@ummc.edu.my --