रक्तदान करें

यह मानव मित्र रक्तदान या प्लेटलेट्स फॉर्म है, अगर आप स्वेच्छा से रक्त या प्लेटलेट्स दान करना चाहते हैं और लोगों की मदद करना चाहते हैं, तो यह फॉर्म आपके लिए है। कृपया इस फॉर्म को भरें, हमारी टीम जल्द ही आपसे संपर्क करेगी।

Important:

Do not donate blood if you may have been exposed to HIV/AIDS, you may be endangering someone's life.
The donor must be fit and healthy, and should not be suffering from transmittable diseases.
The donor must be 18–60 years old and should weigh a minimum of 50 kg.
The time period between successive blood donations should be more than 3 months.

Your Full Name*

Your Father's / Husband's Name*

Your Email ID*

Your Contact Number*

Your Date of Birth*

Your Gender*

Male

Female

Your Blood Group*

What do you want to Donate?*

Blood

Platelets

Both

Why you want to Donate blood?*

Last time when you Donate Blood?

Your Complete Address

Country*

State / Province*

City*

Street Address1*

Street Address2

Postcode / Zip