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Customer Services
Maintenance
Customer Services
Maintenance
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Borang Maklum Balas Pelanggan / Customer Feedback Form
Please fill in this form for further feedback.
Name / Name
No Telefon / Telephone No.
Emel / Email
Tarikh dan masa kejadian / Incident date & time
*
Jenis Maklum Balas / Feedback Type
*
Select type
Compliment / Penghargaan
Complaint / Aduan
Kategori Maklum Balas / Feedback Category
*
Select category
Doktor / Doctor
Kakitangan / Staff
Perkhidmatan / Service
Kemudahan / Facility
Lain-lain / Others
Alamat / Address
*
Keterangan / Description
*
Send
