Feedback Form For Visitors

1 Name :
2 Age : Below 20 year 40-50 year
20-30 year Above 50 year
30-40 year
3 Sex : Male Female
4 E-Mail :
5 Educational
qualification
: Undergraduate Diploma
Postgraduate Professional degree
Others
6 Occupation : Student Professional
Self-employed Others
7 How did you come to know of the Tinplate Hospital website?
Newspaper Friends / relatives
Hoarding Brochures
Others
8 What other information/services would you like to be made available on the site?
9 Kindly read the following statements and choose whichever is appropriate

Note: A*: Extremely satisfied ;
             B*: Satisfied ;
             C*: Neither satisfied nor dissatisfied ;
             D*: Dissatisfied ;
             E
*: Extremely dissatisfied .
 
 
A* B* C* D* E*
a. Content on the site
b. Navigation through the site
c. List of doctors available on the site
d. List of medical specialties available
e. Health news/articles available on the website
f. Feed back/follow up by the hospital
after receiving your queries
g. Speed with which the pages download
h. Graphical appeal of the website
10  Does your organization have a corporate tie up with Tinplate Hospital?
Yes No
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Tinplate Hospital
P.O.Golmuri, Jamshedpur - 831003, JHARKHAND
Phone: 0657-2342266/2342228
Email Contact :DMS Office (TCIL)