Blood Donation Requirement
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Your Name *
The one who is requesting for the blood.
BTC Membership ID
Its an optional field, just for the records.
Contact Person Name *
Whom should donor get in touch with
Contact Person Phone Number *
Blood Group Required *
Requested blood group
Number of Units *
Requirement should be fulfilled by?
Its an optional field, fill only if you know
Hospital Name and Address *
It would be nice if you provide google map link too.
Reason of Blood Requirement
Fill only if you know the reason.
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