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SLIP PERJALANAN DERMA DARAH HTAR
Slip ini bertujuan menggalakkan pendermaan darah anjuran Jabatan Perubatan Transfusi Darah Hospital Tengku Ampuan Rahimah (HTAR) Klang sepanjang tempoh 'Perintah Kawalan Pergerakan' (PKP)
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Email
*
Your email
Nama Penuh
*
Your answer
No. Kad Pengenalan
*
Your answer
No. Telefon
*
Your answer
Tarikh untuk menderma darah
*
MM
/
DD
/
YYYY
Tempat pendermaan darah
*
Centre (HTAR Klang)
Mobile (tempat selain HTAR)
Pihak kami tidak bertanggungjawab atas sebarang penyalahgunaan slip ini. Sebarang pertanyaan berkenaan kesahihan slip ini, sila hubungi nombor 03-33757000 sambungan 1250 (Tabung Darah) pada Isnin-Jumaat (8pagi-5petang)
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