Donate Plasma Save Life - Bhopal Only
This form is made by Bhopal Support Group to identify and connect plasma donors for COVID-19 patients in Bhopal, Madhya Pradesh. Your information is safe with us and will not be released publicly. We will connect you directly with the patient with your consent.
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Name / नाम *
Age / उम्र *
Phone No. / संपर्क नंबर *
Blood Group / रक्त समूह *
Date of Recovery *
If you do not know the exact date, please enter an approximate date. If you are still covid + ve, update the infection date.
MM
/
DD
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YYYY
City / शहर *
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