Follow Us
contact@anticoronataskforce.org
Login
/
Register
Login
Home
About
About Us
Team
Affiliation
FAQ
Donor
Testimonial
Problem
Solution
Need Blood
Activity
Mask Distribution
Food Distribution
Medical Assistance
Citizen Awareness
Sanitization
Online Medicare
Stay at Home
Research
Member
Member's Verification
Our Member
Member Login
Volunteer
Volunteer Verification
Our Volunteer's
Volunteer Login
Intership
Registration Form
Intership Verification
Intership Certificate
Hightlights
Blog
News
Noticeboard
Award
Our Achievment
Our Story
Career
Report
Annual Report
FCRA Report
Audit Report
Event
Upcoming Event
Past Event
Gallery
Photo Gallery
Video Gallery
Contact
Need Blood
Home
Need Blood
Need Blood
Donate Blood
Patient Name *
Patient Dob *
Attendee Name *
Attendee Mobile Number *
Select Blood Group *
Select Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Don't Know
Select Blood Component *
Select Component
Blood
Platelets
Required Date *
Units *
Location For Donation *
Requisition Form From Doctor ( Image) *
Refer By ( If any ) *
Submit
Full Name *
Date of Birth *
Mobile Number *
Email *
Select Blood Group *
Select Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Don't Know
Weight *
Last time donated blood date *
Have you ever been deferred or rejected as a donor *
Select
Yes
No
Current Living City *
Address *
Any medical conditions or allergies *
Select
Yes
No
Any medication that you are currently taking *
Select
Yes
No
How did you hear about Anti Corona Task Force's blood donation drive *
Select
Website
Social Media
Friend
Our Member
Our Volunteer
By submitting this form, I declare that I am in good health and am willing to donate blood voluntarily in case of a medical emergency or as required by Anti Corona Task Force. I understand that Anti Corona Task Force will use my personal information only for the purpose of blood donation and will keep my information confidential.
Submit
Donate Us
Support
Support Ticket
×
Title Name *
Subject *
Email *
Priority
Select Priority
Low
Medium
High
Urgent
Issues
Select Department
Submit Issue
Login Issue
Payment Issue
Cause Issue
Description
Confirmation
Are you sure want to delete?