INPATIENT SATISFACTION SURVEY Choose Language : English Indonesian Inpatient Questionnaire INSTRUCTIONS FOR COMPLETION Place a checkmark in the box (○) that best corresponds to your experience.Our hospital's physical facilities ,including cleanliness, comfort, and the completeness of services.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe atmosphere, cleanliness, and comfort of your room / ward*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe taste and quality of the food you receive during your stay.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe reliability of our officers and staff in serving you.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe speed of the service process you experienced. Admission Department*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedNurse (in responding to bells or calls)*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedCashier Department (during the discharge process)*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedPharmacy Department*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedOther Department (please specify, if any) :Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedDoctor*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedNurse*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedOther Medical Personnel (please specify, if any)Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedAdmission / Registration*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedDoctor*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedNurse*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedOther Medical Personnel*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedCashier / Administration Department*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedOther Staff / Personnel (please specify, if any) :Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedCleaning Staff*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedSecurity Staff*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedAdditionalWould you recommend our hospital to your family / friends / colleagues?*YesNoYour feedback and appreciation are very valuable to us. You may share them in the space below.Name*Mobile Phone No*Date of Birth*Medical Record No (Opsional)Room*Silahkan PilihChoose Ward / RoomArgo RoomArkana RoomArya RoomKirana 1 RoomKirana 2 RoomLaksita RoomBaby Room ICU RoomEmail*Save