Surat Raktadan Kendra & Research Centre :: Surat :: Gujarat

SURAT RAKTADAN KENDRA & RESEARCH CENTRE

Regional Blood Transfusion Centre

Trust Reg. No.: F-218 Licence No.: GB-15

Donar Registration Form

Full Name	:
Date of Birth	:
Age	:
Sex	:	Male Female
Occupation	:
Organization	:
Address	:
Phone No. (O)	:
Phone No. (R)	:
Mobile	:
Email	:
May we talk with you on mobile	:	Yes No
Have you donated before ?	:	Yes No
If yes, how many time ?	:
Last donation date	:
Have you faced any difficulty during/after donation ?	:	Yes No


Security Code:		Please enter the code as you see in the image

	For Blood Donors
-	Why to donate blood
-	Who can donate
-	Who cannot donate
-	Donation process
-	Role of honour
-	Post donation care and counseling
-	One donation helps three

	For Organizers
-	Blood donation camp calender
-	Ideal camp

	Be a Donor
	Online Registration

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