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About Us
Our Mission
Our Vision
Our History
Our Team
Our Trustees
Our Ambassadors
Our Advisors
In Memorium
Our Supporters & Donors
Organ Donation
Organ Transplant Guide
Body Donation Directory
Eye Donation in India
Skin Donation in India
Know Organ Donation
Pledge
Laws & Report
Recipient Information
Activities
Events
Celebrity Bytes
School Programme
Haryana Programe
RTO
Blog
About Us
Our Mission
Our Vision
Our History
Our Team
Our Trustees
Our Ambassadors
Our Advisors
In Memorium
Our Supporters & Donors
Organ Donation
Organ Transplant Guide
Body Donation Directory
Eye Donation in India
Skin Donation in India
Know Organ Donation
Pledge
Laws & Report
Recipient Information
Activities
Events
Celebrity Bytes
School Programme
Haryana Programe
RTO
Blog
Pledge to be an Organ Donor
Pledge Form
Name
*
(To be mentioned as it appears on government issued ID card)
Mother's/Father's Name
*
Current Residential Address
*
Address Line 2
*
City
*
District
*
State
*
PIN Code
*
Mobile Number
*
Occupation
*
--- Select ---
Student
Business
Professional
Self Employed
Government Employee
Armed Forces
Retired
Homemaker
Other
Profession
*
Email
*
Date Of Birth(DD/MM/YYYY)
*
Age
*
Gender
*
---Select---
Male
Female
Other
Blood Group
*
---Select---
A
+
A
-
B
+
B
-
AB
+
AB
-
O
+
O
-
Emergency Contact Name
*
Emergency Contact Number.
*
Emergency Contact Address
*
(Person's Address and Emergency Contact's Address is same)
Choose Identity Card
*
-------Select One -------
Aadhar Card
Enter Identity Card Number
*
Organs that I wish to donate :
*
Corneas (Eyes)
Kidneys
Heart
Lungs
Liver
Pancreas
Small Intestine
Skin
Hand
All Organs
Social Media Profile Link
Where did you hear about us
*
---Select---
Idonate Campaign
Social media
Awareness session
Friends and family
Radio
Sahas-Ek Koshish Jeevan Dene Ki
Accord Superspeciality Hospital
Other
Which Awareness session?
*
I declare that I am a citizen of India and above 18 years of age.
I agree to the privacy policy
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1800-1203-648