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  5. Patient survey
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الخروج من الاستبيان  
 
 
Master in Clinical Pharmacy
Assessment of safe practicing of oral cytotoxic chemotherapy at radiation and Isotopes Center at Khartoum
Patient questionnaire
 
 
 
 
* This questionnaire will be answered by:
 
 
 
* Age of Patient
 
 
 
* Gender
 
 
 
Educational Level
 
 
 
* Diagnosis
   
 
 
 
* No of the visit
 
 
 
Prescribed treatment regimen
   
 
 
 
Actually treatment regimen taken
   
 
 
 
* Did you know how to take your drug regimen?