Form ɗin ziyarar binciken asibiti a gida

Cika form ɗin don bukatarka ta ziyarar binciken asibiti a gida.

Ziyarar binciken asibiti a gida

Cikakken suna *

Mai tallafawa bincike

Imel *

Wayar hannu

Sunan aiki *

Alamomin bincike

Hanyoyin da za a yi a lokacin ziyarar gida

Aunokin rayuwa (zafi, hawan jini, tsayi, nauyi, da sauransu) Aunoki da na’urori na musamman kamar ECG, EEG Sikelai da tambayoyin da mai haƙuri zai cika Mika/ƙidaya samfurin bincike Ɗaukar jini Ɗaukar fitsari Ɗaukar wasu kayan halitta Shirya safarar samfurori da aka ɗauka a gida

Adadin cibiyoyi

Jimillar adadin ziyarar gida

Saƙonka *

Na amince da sarrafa bayanaina na sirri a cikin KVKK/GDPR.