Register as a Blood Donor | Save Lives Now

Full Name / പേര് *

Gender / ലിംഗം *

Date of Birth / ജനന തീയതി *

Age / വയസ്സ് Must be 18-65

Blood Group / രക്തഗ്രൂപ്പ് *

Address / മേൽവിലാസം *

Region / പ്രദേശം *

Country / രാജ്യം *

Mobile Number (Primary) *

Alternate Mobile Number

Email ID

Weight (kg) * Min 45 kg required

Height (cm)

Donated Before?

Last Donation Date

Any major illness?

No Yes

Do you have Diabetes?

No Yes

Do you have issues with Blood Pressure?

No Yes

Any Heart disease History?

No Yes

Do you have Asthma?

No Yes

Recent surgery in last 6 months?

No Yes

Tattoo / piercing in last 6 months?

No Yes

Alcohol consumption in last 24 hours?

No Yes

Are you Pregnant or had a recent delivery?

No Yes

Self-declaration: HIV / AIDS?

No Yes

Self-declaration: Hepatitis B / C?

No Yes

Malaria in recent months?

No Yes

Tuberculosis infection history?

No Yes

COVID infection in last 30 days?

No Yes

Emergency Availability? *

Preferred Contact Time

I confirm that the information provided is true to the best of my knowledge.

I am willing to donate blood voluntarily when contacted.

I accept the Terms of Service & Privacy Policy.

Donor Registration

Sign Up as a Blood Donor

1. Basic Donor Information

2. Contact Details

3. Physical & Health Details

4. Health Screening & Declaration

5. Availability & Consent