Complaints

New Complaint Registration

Full Name*

Gender*

Male

Female

Specialization*

House# / Area / Town / City / Tehsil / District Name / Complete Address / Location*

City Name*

Email Address*

Contact Number 1#*

Contact Number 2#

Machine Type (Ultrasound / Color Doppler / Probe / Echocardiography / ECG / Defibrillator)*

Model Name*

Serial Number of Unit

Describe Fault*

Fill Captcha*

8 + 2 =