Receiver Registration
Personal Details
First Name
Middle Name
Last Name
Email
Mobile Number
Alternative Mobile Number
Identity Details
Date of Birth
Aadhaar Number
Gender
Select gender
Male
Female
Others
Age
Weight
Please select your blood group
Select Blood Group
A+
A-
B+
B-
O+
O-
AB+
AB-
Next
Address Details
City/Village
District
State
Pin Code
Important Details
Date of receiving
Blood type that you want
Select Blood Type
Whole blood
Red blood cell
Platelet
Plasma
Quantity (1 unit = 500ml)
Reason
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Submit
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