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Blood Donors Registration Form
Allahabad Nursing Home Association Charitable Blood Centre
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Blood Donors Registration Form
--Select Gender--
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Female
--Your Blood Group--
A+
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B-
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I have read and understood all the information presented above and answered all the questions to the best of my knowledge, and hereby declare that I agree to display my name and mobile on SBTCUP website with my consent.
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Name
Registration fees
*
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Registration (Existing Member) (1500)
Accompanying person(Above 11 Yrs) (1000)
Registration (Non-Member) (2000)
Spot Registration (3000)
Couple Registration (2500)
Mobile
*
Fees
Name of Consultant/Hospital
*
QR Code
Account
Account Details
Bank Name :
Union Bank of India
Branch Name :
GEORGE TOWN, ALLAHABAD
A/C Holder Name :
ALLD NURSING HOME PRIVATE DOCTORS WELFARE ASSOCIAT
A/C Number :
510101004320688
IFSC Code :
UBIN0905330
PAYMENT INFORMATION
Transaction No*
Pay Date *
Pay Slip *
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