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PLASMA DONATION
For the responsible citizens of Ranchi who want to donate plasma to save a life.
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Supporting Organisations
FIRST NAME
*
Your answer
LAST NAME
*
Your answer
YOUR AGE
*
Your answer
MOBILE NO.
*
Your answer
State and City
*
Your answer
GENDER
*
Female
Male
BLOOD Grp
*
Your answer
When did u get positive result?
*
MM
/
DD
/
YYYY
Do you want to Donate Plasma to save a Life?
*
Yes
No
Maybe
Do you currently have Symptoms?
*
Yes
No
Has it been at least 14 days since the last day of your symptoms ( Covid-19 symptoms include fever, cough and shortness of breath)
*
Yes
No
Not Applicable
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