Donor Registration

Bano Ek Hero 🩸

Sab detail dhyan se bharo. Aadhaar verify hone ke baad hi public list me aayega.

Kya Donate Karna Chahte Ho?

Full Name (as you call yourself) *

Aadhaar Name (exact as on Aadhaar) *

Aadhaar Number (12 digits) *

🔒 Aadhaar poora aapke record me safe rahega. Public me sirf last 4 digits dikhenge.

Age *

Gender

WhatsApp Number *

Primary Call Number *

Email (optional)

City *

State

Pincode

Area / Locality

Full Address (private)

Koi disease hai?

HIV, Hepatitis, Diabetes, etc.

Koi medication le rahe ho?

Last Donation Date (if any)

Kyun donate karna chahte ho?

Occupation

Emergency Contact Name

Emergency Contact Phone

Main confirm karta hoon: