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Organ Donor Card & Pledge Certificate


Donor Card & Pledge Certificate - Registration Form

Personal Details :-

Corneas(Eyes)
Any Organ

Emergency Contact Person Details :-

* Fields are Mandatory

Note: The information which you are entering in the above form is confidential and will be used only for purpose of organ donation and transplant processes and will not be shared/used for any other purpose. Pledge Certificate will be sent on WhatsApp Right now While Donor Card will be sent in few days.


# Incase of any difficulties in filling this online form, Whatsapp on 7004315108