Issue Number as seen Above
Where is the Issue? ---HospitalStreetCommunitySchoolOthers
Whats the Other Issue?
Whats Wrong at the Hospital? ---No medicineNo doctors / nurseRude StaffNot cleanOthers
Name of Hospital / Clinic
Hospital / Clinic Location
Whats Wrong in the Streets? ---Garbage not collectedStreet lights not workingBad roadNot cleanOthers
Name of Street
Street Location
Whats Wrong in the Community? ---Unclean waterUnsafe electrical wiringsBad roadBad drainageOthers
Name of Community
Community Location
Whats Wrong at the School? ---No desksNo teachersUnclean environmentNo books for Pupils/StudentsOthers
Name of School
School Location
Your Gender * ---MaleFemalePrefer not to Say
Your Phone Number *
Your Age *
Do you want to Attach photos/videos?
Should we hide your Identity? ---YesNo
Note: Before reporting take a screenshot or memorise the Issue number on top. Keep it safe you can use it to track response to your issue, re-report it or give us feedback if the issue has been addressed before we take our actions.
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