Name

Email

Phone number

How was your overall experience ?
8-10 - Good3-7 - Average1-7 - Sad

What you think can we improve?
Doctor FriendlinessExplanation of Health IssueTreatment SatisfactionWait TimeMira Team FriendlinessMira Team Efficiency

Would you like to recommend the doctor to Family & Friends?
YesNo

For which health problem did you visit?

Stomach ProblemGastritisPilesHaemorrhoidsFissureFistulaBreast LumpBreast PainSwelling in Abdomen

What treatment did you undergo?

Medical TreatmentNon Surgical Treatment for Haemorrhoids / FissureLaser Piles / Fissure Treatment / SurgeryLaser Fistula SurgeryLaparoscopic Hernia AllergyBreast Surgery

Tell us about your experience with the doctor.