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Donate Plasma - Save Smiles
Gujarat Congress urge you to come forward, donate plasma and save lives in this crucial time
In Association with Indian Red Cross Society
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* Indicates required question
I want Plasma
Plasma Seekers
Name (નામ)
*
Your answer
Phone Number (ફોન નંબર)
*
Your answer
Date of Birth (જન્મ તારીખ)
*
MM
/
DD
/
YYYY
State (રાજ્ય)
*
Your answer
City / District / Taluka (શહેર / જિલ્લો / તાલુકો)
*
Your answer
Pin Code (પિન કોડ)
Your answer
Blood Group (બ્લડ ગ્રૂપ)
*
Your answer
Is patient currently hospitalized? (શું દર્દી હાલમાં હોસ્પિટલમાં દાખલ છે?)
*
Yes
No
If yes, Please mention hospital name and address (જો હા, તો હોસ્પિટલનું નામ અને સરનામું જણાવવા વિનંતી)
Your answer
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