Aasra Welfare Society Bathinda
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Register Your Self as Donor
The Blood You Donate Gives Someone Another Chance At Life.
Donor's Registration Form
Name:
Father's Name:
Contact No.:
Location:
City:
State:
Blood Group:
A+
B+
AB+
O+
A-
B-
AB-
O-
Last Blood Donation Date:
dd-mm-yyyy
How many Times you donated Blood ?:
Remarks: