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Give the message of life to those who are on their deathbeds and waiting for your donation. Committed and regular donors are required for blood donation.
 
 
Registration Form
   
Full Name*:
Blood Group *:
Gender *:
Date Of Birth* :
(DD/MM/YYYY)
   
Contact Information
   
Mobile Number*:
(Eg: 0332-9622056)
Select City *:  
E-Mail*:
Permanent Address* :
User ID*:
Password*:
Re-type Password*:
Last donatind date *:
Please confirm your
availability to donate
blood*
I authorise the website to display my telephone number, e-mail ID and mailing address so that the needy could contact me, as and when there is an emergency.
   
Enjoy the good feeling that you have saved a life and give a hope of life to the patient.
   
   
 

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