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A healthy person can safely give blood every 3-4 months.

A person weighing between 45 Kg to 55 Kg can donate 350 ml of blood.
Age limit : 18 to 60 years.

Personal Information

Title :

First Name :

Middle Name :

Last Name :

Sex :

Male        Female

Age :

Blood Group :

Weight :

Height :

Address :

State :

City :

Phone1 :

Pin code :

Phone2 :

Fax :

       

Additional Information 

  Have you donated blood
       before
  Have you undergone
       surgery before
Last date of blood donation :   Last date of Surgery :  
  Have you had blood
       transfusions
  Have you received any
       treatment recently
  Have you had any sexually
       transmitted disease?
  Have you ever had JAUNDICE
       (Yellowness of eye)
  Have you been addicted to
       drugs?
  Have you taken any vaccine in
       the past one month
  Have you or your spouse ever tested positive for AIDS antibody or co-habited with
       a person having AIDS? 
  Other Venereal Disease
 

 

 
 

  

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