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You need the therapy
Please fill the form if you are looking to get the plasma therapy for your loved one. Please make sure that the information is genuine, as we will be verifying the details submitted.
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Your Name
*
Your answer
Contact Number (Patient/Attendant)
*
Your answer
City
*
Your answer
Hospital Name
*
Your answer
Blood Group
*
A +ve
A -ve
B +ve
B -ve
AB +ve
AB -ve
O +ve
O -ve
Any Blood Group
Required
Age
*
Your answer
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