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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
Request Form
Home
Request Form
Request For Blood
Request Form
Patient’s Name
Hospital
Address
Amount of blood(how many pint)
Blood Group
Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
When You Need
Types of Blood
Blood Type
Fresh
PRP
FFP
PCV
other
Contact Number
Remarks