I will Donate

If you are interested in donating Blood or have already donated blood, please register by providing basic information -

(Fields with * mark are mandatory.)

Address Line1 : Address Line2 : Address Line3 :
State : District : City :
PIN :
Address Line1 : Address Line2 : Address Line3 :
State : District : City :
PIN :
Office Phone No : Home Phone No : Office Mobile No :
Mobile Phone No.1 * : Mobile Phone No.2 :
Official Email 1 : Official Email 2 : Personal Email 1 * :
Personal Email 2 : Personal Email 3 :
Have you donated Previously? : Blood Group* : Is Blood Group Confirmed? :
Sl.NoNameAGEBlood GroupOccupationDate Of BirthGenderCorrespondence AddressRegistration DateMobile NoEmail
1 Mr. Debajyoti Pati A+Employee30/07/1988Male 21/07/20158984255908pati.debajyoti@gmail.com
2 Mr. abc A+Student21/07/2015Male 21/07/20159999999999abc@gmail.com
3 Mr. abc AB+Student08/07/2015Malepatna,patna,patna,Bihar,Patna,patna,15644621/07/20159999999999abc@gmail.com
4 Mr. xxxxxxxxxxxxxxxxxxxxxxxxxx O+Student02/08/2015Male 02/08/20150000000000xxxxxxxxxxxxx@gmail.com
5 Mr. vimal prakash36A+Employee03/02/1979Male 06/08/20159430481353vimal.prakash79@gmail.com
6 Mr. Kumar Phanishwar31B+Employee21/12/1983MaleC/o G.K. Sinha H/o Kulesh Mistery,Kulesh Bhawan House No.- 04,Road No.- 08 Indrapuri Patna,Bihar,Patna,Patna,80002419/08/20158986563725phanishwar.kumar25@gmail.com
7 Mr. Manoj Kumar Jha53AB+Govt.Employee07/01/1962MaleB-13 Gandhi Vihar,Police colony, Anisabad,Patna,Bihar,Patna,Patna,80000226/08/20159334121705manojkumarjha1962@gmail.com
8 Mr. surendra prasad sinha37A-Govt.Employee15/12/1978MaleBLOOD BANK,Sadar hospital aurangabad,Bihar,Bihar,Aurangabad,aurangabad,82410105/09/20159431182606spsurendraprasad1@gmail.com
9 Mr. Mukesh Kumar Hissariya43B+Other12/02/1972Male 17/09/20159835093446mukesh1972@rediffmail.com
10 Mr. SADANAND AGRAWAL45B+Other30/12/1970Male 23/09/20159431035481motorspares@rediffmail.com
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