Blood Donor Registration

Register as a voluntary blood donor with Indian Red Cross Society Korba. Your one donation can save up to 3 precious lives.

1 Personal Details

Full Name *

Father's / Husband's Name

Date of Birth *

Gender *

Male Female Other

2 Medical & Blood Group Information

Blood Group *

Approximate Weight (kg) *

Last Donation Date

Any Major Medical Condition?

No Yes

3 Contact & Residential Location in Korba

Mobile Number *

Emergency Contact Number

Email Address

Area / Local Colony in Korba *

Complete Residential Address *

I confirm that I am between 18 and 65 years of age, weigh at least 45 kg, and volunteer to donate blood for patients in need. I authorize Indian Red Cross Society Korba to contact me for emergency blood donation drives. *

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Blood Donor Registration

1 Personal Details

2 Medical & Blood Group Information

3 Contact & Residential Location in Korba

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