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FORMULIR KELUHAN PASIEN/KELUARGA RUMAH SAKIT KHUSUS IBU DAN ANAK (RSKIA) SUKMA BUNDA Rawat Jalan Rawat Inap ……………………………….. Nama Alamat/Telepon Tanggal Jam
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Kritik/ Saran : …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… .
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RSKIA SUKMA BUNDA Jl. Soekarno-Hatta Kel. Bulakan Balai Kandi Kec. Payakumbuh Barat Phone: (0752) 95871. Fax: (0752) 92228