TRIAGE

Self Checker Form

"Multi-step clinical screening form to assist in determining the appropriate treatment facility.

Type of Service Required?

Gender

Patient's Age?

Does the patient have any existing health conditions?


Is the patient conscious ?

Does the patient have difficulty breathing?

Does the patient have chest pain?

Is the patient experiencing seizures?

Does the patient have stomach pain?

Has the patient sustained any injury or been involved in an accident?

Does the patient have any bleeding?

Does the patient have any questions?

Does the patient require ambulance services?


List of Klinik Kesihatan near you

# NAME INFORMATION


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Click Here CALL 999 OR Dial 999

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List of Klinik Kesihatan near you

# NAME INFORMATION


Start over ➜

List of Klinik Kesihatan near you

# NAME INFORMATION


Start over ➜

Click above to be connected to the officer on duty

Or Click Here CALL 999 OR Dial 999


Start over ➜