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Genowa Governor's Cup 2023

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When:
Nov 20, 2023
08:09 am - 06:09 am

Where:
Raila Odinga Stadium,
Homa Bay

Homa Bay County

P.O Box 469 - 40300, Homabay
[email protected]
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Request an Ambulance

Patient Information

Firstname

Lastname

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Clinical Information

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FLLoCA Grievance Redress MechAnism (GRM)

SECTION A: Personal Information (Provision of information in this section is voluntary)

Complainant’s Name

ID Number

Phone Number

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Email Address

Sub County

Ward

Village

SECTION B: Complaint Lodge

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Name/Department/Sub-county/Ward/Agency

Have you reported this matter to any other county official/office? YES/NO

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If YES, which one?

Has this matter been the subject of court proceedings? YES/NO

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No

If NO, please give a brief summary of your complaint and attach all supporting documents (Indicate all the particulars of what happened, where it happened, when it happened and by whom)

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