DEPARTMENT OF TRANSFUSION MEDICINE
*Please click according to the service you received
*
Donation Date :
*
Donor Name :
Mobile No :
VENUE
Sufficiant Area
Excellent
Good
Unsatisfactory
Lighting & Ventilation
Excellent
Good
Unsatisfactory
Cleanliness
Excellent
Good
Unsatisfactory
REGISTRATION
Welcome at Registration
Excellent
Good
Unsatisfactory
PRE DONATION COUNSELLING
Comprehension (easy to understand)
Excellent
Good
Unsatisfactory
PRO willingness to answer your queries related to Blood Donation
Excellent
Good
Unsatisfactory
PHLEBOTOMIST (One who collecting blood)
Courteous Behaviour
Excellent
Good
Unsatisfactory
Comfortness during Blood Donation
Excellent
Good
Unsatisfactory
Post Donation advice given
Excellent
Good
Unsatisfactory
Phlebotomist’s willingness to answer your queries related to Blood Donation
Excellent
Good
Unsatisfactory
POST DONATION
Refreshments
Excellent
Good
Unsatisfactory
Overall Satisfication
Excellent
Good
Unsatisfactory
Suggestion for Improvement :