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Biratnagar-6, Koshi Province
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About
Team
Message From Chairman
Stories
Donor
Visitor
Membership
Request
Blogs
Gallery
Contact Us
Donate
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Become a Donor
Donor Form
Name
Address
Date of Birth
Blood Group
Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Contact Number
Email
Have you donated blood before?
When you donate last time? (Mention date)
Do you have any health conditions that may prevent you from donating blood?
Are you willing to donate blood in emergency situations?
By submitting this form, I agree to allow TatkaalRaktada (Instant Blood Donor) to contact me in case of emergency blood donation and to use my information to build a database of potential blood donors.
