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Hospital And Treatment Details
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--Select City--
AGRA
AHMEDABAD
AMRITSAR
BANGALORE
BILASPUR
CHANDIGARH
CHENNAI
DELHI/NCR
GANDHINAGAR
GUNTUR
GURGAON
HYDERABAD/SECUNDERABAD
INDORE
JAIPUR
KAKINADA
KOLKATA
LUDHIANA
MOHALI
MUMBAI
MYSORE
NAVI MUMBAI
NELLORE
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RAICHUR
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If Other *
Select Hospital *
-- Select Hospital --
Artemis Hospital
Centre for Sight, Faridabad
Centre for Sight, Gurgaon
Centre for Sight, Preet Vihar
Centre for Sight, Safdarjung Enclave
Dharamshila Hospital and Research Centre
Fortis Flt Lt Rajan Dhall Hospital
Fortis Hospital Noida
Healing Touch Hospital
Holy Family Hospital
Indraprastha Apollo Hospital
Jaipur Golden Hospital
Max Devki Devi Heart and Vascular Institute
Max Hospital Pitampura
Max Super Speciality Hospital Saket
Meena Devi Jindal Medical Institute & Research Center
Orthonova Hospital
Shanti Mukund Hospital
Shri Ram Singh Hospital and Heart Institue
Shroff Eye Hospital
Sir Ganga Ram Hospital
St Stephens Hospital
Walia Nursing Home
Add New Hospital *
What Treatment / Consultancy / Test were you there for *
Name of Doctor *
-- Select Doctor --
Dr Amit Shrivastava
Dr Anuj Dogra
Dr Anurag Khaitan
Dr B K Garg
Dr Chandra Kant
Dr D K Jhamb
Dr Indu Bansal
Dr Ira Chopra
Dr Kapil Aggarwal
Dr Prof V S Mehta
Dr Rajnish Kumar
Dr Rajnish Monga
Dr Raman Sethi
Dr Ravi Sauhta
Dr S M Shauib Zaidi
Dr Sanjay Verma
Dr Sanjeev Chaudhary
Dr Subhash Jangid
Dr Sudip Raina
Dr Sudip Raina
Other
If Other *
When did the surgery/treatment take place? *
Month
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Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
What is your feedback be on the hospital in terms of its facilities, the doctor, service, cost etc.?
What would you tell a person who is considering getting a treatment done at this hospital?(in 50 – 100 words)
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Infrastructure and Facilities
Medical Equipment
Room /Bed Quality
Cleanliness
Facilities for Friends & Family Accompanying
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Doctor Quality
Expertise of Doctor / Physician
Helpfulness & Communication
Correct Diagnosis
Effective Treatment / Sergery
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Service Quality
Timeliness / Punctuality of Medical Care
Standard of Nursing Care
Staff Behaviour and Service
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Overall Rating for the Hospital
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Other Important Questions
Overall treatment expense
---Select Expense---
Less than Rs.10,000
Rs.10,000 - Rs.20,000
Rs.20,000 - Rs.50,000
Rs.50,000 - Rs.1 lakh
Rs.1 lakh – Rs.2 lakh
Rs.2 lakh and above
No. of Days spent in the Hospital
---Select Days---
Less than 3 days
3 days – 1 week
1 -2 weeks
More than 2 weeks
Would you recommend the same to others
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No
Are you happy with the results of the treatment/visit
Yes
No
Title of the review
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Personal Information
Name *
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Age of Patient *
--Age Group--
<20
20 - 30
30 - 40
40 - 50
50 - 60
>60
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