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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
Occupation
Sex

Organization
Address
Pincode
District
Fax No
Phone No
Mobile No
Would you like to call on your mobile ?

Have you donated previously ?

How Many times ?
When Last Donated ?
When would you like to donate next time ?
When would you like to donate ?
Other