Home Donor Registration

Donor Registration

By registering to donate blood you can also avail the blood bank facilities at select blood banks for repetitive donors

Login Details
Email
Password
Donor Details
Name
Father's Name
Date Of Birth	Warning: date(): It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Moscow' for 'MSD/4.0/DST' instead in /var/www/mahasbtc.com/donor/Formitable.class.php on line 1255 Warning: date(): It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Moscow' for 'MSD/4.0/DST' instead in /var/www/mahasbtc.com/donor/Formitable.class.php on line 1258 Warning: date(): It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Moscow' for 'MSD/4.0/DST' instead in /var/www/mahasbtc.com/donor/Formitable.class.php on line 1264 Warning: date(): It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Moscow' for 'MSD/4.0/DST' instead in /var/www/mahasbtc.com/donor/Formitable.class.php on line 1267
Age
Blood Group	A+ A- B+ B- O+ O- AB+ AB-
Occupation	Select Occupation Advertising / Marketing / PR Aerospace Agriculture / Chemicals / Forestry Automotive Computers / Electronics Construction Consumer Goods Education (includes students) Energy / Mining Finance / Insurance / Real Estate Government / Military / Public Service Hospitality / Recreation Media / Publishing/Entertainment Medical / Health Services Pharmaceuticals Retail Services Telecommunications / Networking Travel / Transportation Student Other
Sex	male female
Organization
Address
Pincode
District	Ahmednagar Akola Amravati Aurangabad Beed Bhandara Buldhana Chandrapur Dhule Gadchiroli Gondia Hingoli Jalgaon Jalna Kolhapur Latur Mumbai Nagpur Nanded Nandurbar Nasik Osmanabad Parbhani Pune Raigad Ratnagiri Sangli Satara Sindhudurga Solapur Thane Wardha Washim Yavatmal
Fax No
Phone No
Mobile No
Would you like to call on your mobile ?	yes no
Have you donated previously ?	yes no
How Many times ?
When Last Donated ?
When would you like to donate next time ?
When would you like to donate ?	Enter a date My Birthday Every 3 months Every 6 months Jan 26 - Republic Day Jan 30 - Martyors day Feb 11 - World Day of Sick Mar 12 - National Volenteers Day Apr 7 - World Health Day May 8 - Red ross Day Jun 14 - World Blood Donor Day Jul 26 - Kargil Day Aug 15 - Independence Day Oct 1 - All India Blood Donation Day Oct 25 - United Nations Day Nov 18 - Arm Day Dec 1 - World Aids Day Other
Other