FORM PARTISIPASI
Terimakasih telah berpartisipasi di acara Nasional Blood Donation bersama Yayasan Nurul Hayat dan Pundi Amal SCTV serentak di 10 Kota besar Indonesia. pada 17 April 2016
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Donor darah di kota *
Nama : *
Jenis Kelamin : *
No. HP : *
Email : *
Mengetahui acara ini dari : *
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