Blood Donor Registration

Blood Donors, Kindly Register Here:

Name*

Contact No.*

Email*

Gender*
MaleFemaleOther

Age*

Blood Group*
A+A-B+B-O+O-AB+AB-

Donation Frequency*
Regular DonorOn Need BasisFirst Time Donor

Last Blood Donation Date*

Address*

City*
DelhiGurugramNoidaGhaziabadFaridabad

Any Comments (Optional)

Yes I am voluntarily registering as a blood donor. I have read the eligibility criteria and confirm that I am eligible to donate blood. I authorize Radhika Prahlad Foundation Trust(RPFT) to display my name, mobile/telephone number, email address and/or postal address to the person who is in need of blood. I release RPFT and its all organizers, trustees, volunteers from all damages whatsoever and waive all rights to compensation in case injury or loss. I agree to receive information about RPFT through various media including print and electronic media with a facility to opt-out.