Donor Registration Form
Date of Birth
Driving License Number
Contact Details of Kin
I wish to donate
Any Part of the Body
I am aware that if I agree to release information from my submission, it will be widely available. That is, it may be placed on Shatayu website and made available in hard copy. I am also aware that the information may be further referenced in later publications. Any personal information provided, such as contact details will be disclosed to the members of Shatayu. Such information will be used or disclosed for any other purpose, without prior written consent. The Shatayu Organ Donation Register allows the rerieval of a donor's written consent on donating his/her relatives and helps them to fulfill their loved ones last wish. The donor may revoke the registration at anytime by informing Shatayu foundation of Organ Donation in wirting
I accept all the conditions mentioned above.
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