রক্তদাতার তালিকাভুক্তি ফর্ম (Donor List Add Form)

সতর্কবাণী :
কেউ কোন শর্তারোপ করে রক্ত দিতে চাইলে ;বা রক্ত কেনা-বেচার চেষ্টা করলে, রক্ত নেয়া থেকে বিরত থাকুন।
এ বিষয়ে অভিযোগ প্রেরণ করুন

Blood Donors Register

Please fill the following information to register donor.

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Full Name

User Name

E-Mail ID

Blood Group —–Select—– A+A-B+B-O+O-AB+AB-A1+A1-A1B+A1B-A2+A2-A2B+A2B-

Availability to donate blood —–Select—– Available Unavailable

Date Of Birth

Mobile Number

Land Line Number

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আমি এই মর্মে অঙ্গিকার করছি যে, কেউ আমার কাছে রক্ত চাইলে বিনা শর্তে স্বেচ্ছায় রক্ত দান করব।

Add Me In Donor List (আমাকে রক্তদাতার তালিকাভুক্ত করুন)