Blood Donor Registration - Village Connect

Registration Form

State *

District *

Mandal

Village

Full Name *

Age (18+) * Must be between 18 and 70 years

Blood Group *

Mobile Number * Format: 10 digits (e.g., 9876543210)

Email (Optional)

I solemnly declare that I am in good health and meet all eligibility criteria for blood donation. I consent to display my details publicly for people in need. I understand all risks and health considerations.

Why Donate Blood?

Every donation saves up to 3 lives!

Blood donation is safe, simple, and helps patients in:

Emergency & accidents
Major surgeries
Cancer treatments
Chronic diseases
Childbirth complications

Benefits of Donating:

Free health checkup
Refreshments provided
Certificate of appreciation
Life-long satisfaction

Important Note

For added safety, women may choose to register with a trusted male family member's name if preferred.

Next Camp: Vijayawada, 25th January 2025

Become a Blood Donor

Registration Form

Why Donate Blood?

Important Note