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Blood Donor's Registration

Choose Picture
!enter donor name!
!enter father name!
!enter mother name!
!enter date of birth!
!select blood group!
!enter Weight!
!select gender!
!enter email Id!
!enter mobile number !
!enter address !
!enter city !
!enter pin !

Please check your eligibility to donate blood

My hemoglobin is not less than 12.5 grams
I am free from acute respiratory diseases and skin diseases
I do not carry any disease transmissible by blood transfusion
I am not under medication for Malaria / Tuberculosis / Diabetes / Fits / Convulsions

I have not suffered from #

Hepatitis B, C
Kidney disease
Heart disease

# Please consult your physician to check for eligibility.

I have read the above eligibility criteria and confirm that I am eligible to donate blood.
!enter username !
! enter password !
!enter username !
I have read the Eligibility Criteria and confirm that I am eligible to donate blood.
I agree to the Terms and Conditions and consent to have my contact and donor information published to the potential blood recipients.

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