Blood Donors Registration Form

Please provide the requires Details as all fields are Mandatory.

Personal Details

 
 
 
 

Contact Details

 
 



'*'Mandatory Fields

 
 
 
 





















I have read and understood all the information presented above and answered all the questions to the best of my knowledge, and hereby declare that
  • I am ready to donate blood if requested by Blood Center/ patients/ patients relatives voluntarily on my own free will, without any expectation of replacement of blood, or any favour in form of cash or kind.
  • Donation of Blood/ Components is a Medical Procedure and I accept the risk Associated with Blood Donation Procedure.
  • My Blood or Blood products may be utilized by the Blood Center for unknown recipient requiring blood/blood products or may be disposed off as per Blood Center norms or Government policy.
  • I fully understand that voluntary blood donation is a humanitarian service and the persons demanding my blood may be in the state of stress. I hereby declare that under such circumstances I shall patiently handle the situation and keep my cool while contacting me even if during Odd hours/time. In case of unavoidable circumstances I shall write to SBTC, UP to withdraw my offer as voluntary blood donor and to remove my name from voluntary blood donor list on the website without any conflict.
  • My Blood will be Tested for Hepatitis B, Hepatitis C, Malaria Parasite, HIV and Venereal Diseases in addition to any other screening tests required for ensuring Blood Safety.
  • All disputes are subject to Lucknow Jurisdiction only.

Your Personal Information is Never Sold nor will We Share with Any of There Company or Organization without Prior Consent.

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