Test Survey By Mahesh

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Survey Posted By

ShalinaAdmin

Interests

Cardiology

Speciality

Cardiology

Start Date

Fri, 03/27/2026 - 18:20

End Date

Mon, 03/30/2026 - 18:14

Survey Question Bank

What is your age group?

1-5 years

5-20 years

21- 40 years

Above 40 years

Describe your experience with the healthcare system in your area.

What is your main health concern?

Which healthcare services are available in your community?

General Practitioner

Specialist Doctors

Pharmacy

How would you rate the cleanliness of your local healthcare facilities?

Do you have access to clean drinking water?

Yes

On a scale of 0 to 10, how would you rate the availability of emergency medical services in your area?

What improvements would you like to see in the healthcare system?

Do you have a copy of your immunization record? Please upload it below.

One file only.
1 GB limit.
Allowed types: gif, jpg, jpeg, png.

How would you rate the friendliness of healthcare staff in your area?

On a scale of 10 to 100, how would you rate the cleanliness of the healthcare facility in your region?

Upload an image of your health insurance card.

One file only.
1 GB limit.
Allowed types: gif, jpg, jpeg, png.

Did you find this survey useful?

Which disorders are you diagnosed with?

Countries of release

India

Description

This is sample survey run by testing team. Please cooperate.

Thanks

Testing team

Multiple Submission

Survey Type

Open

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