Register Donor

Donor Registration

DONOR CONSENT

I am donating blood voluntarily without any force or compulsion. I have not received any remuneration for the same.
I understand that any willful misinterpretation of facts could transmit infection & endanger patient’s life receiving my blood.
I give my consent for appropriate use of blood donated by me in the manner Blood Bank considers best.
I understand that the tests carried out in Blood Bank are only screening tests and confirmatory tests will have to be carried out for confirmation of diagnosis.
I agree to follow the instructions given to me by the Blood Bank, during and after blood donation and accept thhe responsibility of any conseqences of not following those instructions.
I give my consent to test my donated blood for mandatory tests like: HIV 1 & 2, Hepatitis B, Hepatitis C, Syphilis, Malaria

Registration Form

Full Name: *

Phone Number: *

Eamil id: *

Address: *

I want to donate: *

Gender *

Male: Female: Others:

Blood Group: *

Date of Birth: *

Wish To Donate On Date: *