Plasma Donor Registration, Government of Tamil Nadu
தன்னார்வ பதிவு, தமிழ் நாடு அரசு
Plasma Donor Self Registration
Select the District
Plasma Donor Name (50 Chars)
Select the Gender
Mobile No. (+91)
Re-Type Mobile No. (+91)
Date of Diagnosis
Positive Confirmation Report Date
Hospital Treated with Reg No.
Date of Discharge
Negative Confirmation Report Date/Date of Complete Recovery
Brief Clinical History
Consent : I understand that, 1. Plasma donation is a voluntary act & no inducement or remuneration will be offered
2. My blood will undergo various screening tests required to ensure safety of the unit collected.
3.My donated plasma may be given to patients (currently infected with COVID-19), who are likely to benefit from it. I am eligible & give my consent on the above understanding for donating plasma.
What's 13 + 9
represents mandatory field(s).
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