Registration for Blood Donation Camp 2013: NSS, IIT Kharagpur

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NSS, IIT Kharagpur organizes a Blood Donation Camp jointly with B.C.Roy Hospital, IIT Kharagpur and with kind support of physicians and technical team of Sub Division Hospital. It will be held on 16th Mrach, 2013, Saturday (10 AM to 1 PM). Please join the initiative. Please spread the word and save lives! An early registration is requested.

The information provided by you will be kept confidential and will not be used for any other purpose. All necessary precautions like use of disposable syringes, presence of qualified physicians etc. have been taken care of.

Please write your name. *

Please write your email id. *

Please write your phone number. *

Please select your blood group and Rh factor from the list *

(Please select 'Not Known' if you do not know it.)

Have you donated blood before? *

Yes

Please select one from the following list. You are .... *

Kindly share with us your valuable comments / suggestion, if any.

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