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Patients
Register
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Contact
Donate
Be Ishani Rawat’s Lifesaver
Register as a Blood Stem Cell Donor
Please fill below form
Are you between the age group of 18 and 50
Yes
No
Have you already registered with any other blood stem cell donors registry?
Yes
No
Do you live in India?
Yes
No
Are you suffering from HIV, Cancer Or Bleeding disorders?
Yes
No
Enter your weight [Eligible 40 to 130kgs]
Personal Information
Name
Gender
Male
Female
Email
Address
City
State
Pincode
Phone
Email
Special instructions for Kit Delivery
How did you know this campaign?
Declaration of Consent
Your personal data will ONLY be used for finding a matching blood stem cell donor as well as for DATRI to reach out to you with our periodic updates and other relevant information. Our donor database is encrypted and saved in protected servers to ensure confidentiality.
Consent
I hereby consent to DATRI using my personal data for sending me the Donor Registration kit consisting of Donor Registration Form, Donor Consent Form, Swab kit.
I consent to provide my data as required by the registration form and am willing to agree with the sections as given in the Donor consent and declaration form. If you have any queries, please write an email to info@datri.org
Register Now
