Blood Donor Registration

Kindly read the Eligible criteria before fill the form: View Eligible Criteria

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Persons with the following conditions are not eligible to donate blood

Malaria (within 1 year)

Hepatitis B, C *

Any other type of Jaundice (within 16 years)

AIDS

Tuberculosis (within 2 years)

Diabetes (are you under medication currently?)

Fits/ Convulsions (are you under medication currently?)

Cancer *

Leprosy or any other infectious diseases

Any allergies (Only if you are suffering from severe symptoms)

Hemophilia/ Bleeding problems *

Kidney disease *

Heart disease *

Chicken Pox (within 1 year)

Hormonal disorders *

Hemoglobin deficiency / Anemia (recently)

Drastic weight loss (recently)

Small Pox Vaccination (within the last 3weeks)

Blood Donation (within the last 3 months)

Blood Transfusion (within the last 6 months)

Major Surgery (within the last 3 months)

Pregnancy (within the last 6 months)

Organ Transplant (within one year)

We are very glad that you want to signup as donor.
We remind you of your responsibilities because you carry hope for those in dire need.
To register as a blood donor is a responsibility.
Once you are a registered donor, implies that you will be glad or privileged to donate blood at all possible times.

We respect your privacy. We will never rent, sell or give away your email to any third party.

Future Login information

* Username

Enter Username. {Max 15 and Min 4 chrs}

* Password

Enter Password. {Max 20 and Min 4 chrs}

* Retype Password

Enter Retype Password. {Password and Retype Password must match}

Donor Information

* Name	Enter your Name
* Gender	Male Female
Photo	Optional
* Date of Birth	Select Day Select Month Select Year
* Weight	Enter your Weight kgs
* Blood Group	Select your Blood Group
Last Donation
Frequency

Contact Information

* State/City	Select your Living Area
* Mobile No	Enter your Mobile No
* Res Phone No	Enter your Residence Phone No
* Off Phone No	Enter your Office Phone No
* Email	Enter your Email
Address
Personal Message

Form Verification

* Enter the code	Enter the Verification Code

I have read the eligibility criteria and confrim that eligible to donate blood. Important: I authorize the website to display my telephone number, e-mail ID and mailing address so that the needy could contact me, as and when there is an emergency. I will inform the website at info@indiabloodbank.com as soon as I donate blood so that contact information/Last donation is updated.