The Clinical Establishments (Registration and Regulation) Act, 2010
Application for Grievance
All fields marked with * are mandatory
Complaint Classifications
Complaint Against
*
Select Complaint Against
Doctor/ Staff related
Hospital Administration
Others
Category
*
Select Category
Sub Category
Select Sub Category
State
*
Select State
ANDAMAN & NICOBAR ISLANDS (UT)
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH (UT)
CHHATTISGARH
DAMAN AND DIU (UT)
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR - Jammu Division (UT)
JAMMU AND KASHMIR - Kashmir Division (UT)
JHARKHAND
KARNATAKA
KERALA
LADAKH (UT)
LAKSHADWEEP (UT)
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NCT OF DELHI (UT)
ORISSA
PUDUCHERRY (UT)
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
THE DADRA AND NAGAR HAVELI (UT)
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
District
*
Select District
Establishment
*
Complaint Details
Description of Complaint
*
Word Count :
0
Personal Details
Name
*
Email
*
Mobile Number
*
Address
Word Count :
0
State
*
Select State
ANDAMAN & NICOBAR ISLANDS (UT)
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH (UT)
CHHATTISGARH
DAMAN AND DIU (UT)
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR - Jammu Division (UT)
JAMMU AND KASHMIR - Kashmir Division (UT)
JHARKHAND
KARNATAKA
KERALA
LADAKH (UT)
LAKSHADWEEP (UT)
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NCT OF DELHI (UT)
ORISSA
PUDUCHERRY (UT)
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
THE DADRA AND NAGAR HAVELI (UT)
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
District
*
Select District
Pin Code
