Blood Donation Registration - Udyam Social Development Foundation

Urgent Blood Requirement or Hospital Emergency?

Call our 24/7 Golaghat emergency blood coordination cell or submit the blood request form below for prompt assistance.

Call Emergency Help

1. Personal Information

Full Name *

Guardian Name *

Date of Birth * Donor must be between 18 and 65 years old

Aadhar Number * 12-digit Indian National Identity Number

Blood Group *

2. Address & Location Details

Full Address (House/Street/Road) *

Village / Town / Ward No *

Post Office (P.O.) *

Police Station *

District *

PIN Code *

3. Contact Information

Mobile Number *

WhatsApp Number * Same as Mobile

Email Address *

4. Blood Donation History

Total Times of Blood Donated * Enter '0' if this is your first time registering as a donor

Last Date of Blood Donation Leave blank if you have not donated blood previously

5. Required Documents (Photo, Aadhar Card, Signature)

1. Passport Size Photo *

Upload Photo

JPG, PNG, WEBP (Passport size)

2. Aadhar Card *

Upload Aadhar Card

Image or PDF (Front & Back)

3. Signature *

Upload Signature

Sign on paper & upload photo/PDF

I hereby declare that all information provided above is true and correct to the best of my knowledge. I voluntarily register with Udyam Social Development Foundation as a voluntary blood donor, and consent to being contacted when urgent blood donation is needed for patients in our community.

Urgent Patient Blood Requirement Form

Please fill in the patient and hospital requirements below. Udyam Social Development Foundation will promptly coordinate with our verified voluntary blood donor network in Golaghat & surrounding regions to arrange donor support.

1. Member Verification (Compulsory)

Blood requests are available exclusively for registered members of Udyam Social Development Foundation. Please provide your unique Member Registration Number and upload your official member registration slip (PDF) for verification.

Member Registration Number * Your unique Udyam Foundation membership ID as shown on your registration slip

Member Registration Slip *

Upload Member Registration Slip

PDF format only · Max 5 MB

Your official Udyam Foundation membership registration slip

2. Patient Information

Patient Name *

Patient Guardian Name *

Patient Age * Patient's age in completed years

Required Quantity of Blood * Number of units/bags needed for transfusion

Date When Blood is Required * Date by which blood must be available

Patient Blood Group *

3. Contact Details (Attendant / Relative)

Contact Number * Our blood coordinators and donors will call this number

WhatsApp Number * Same as Contact

For urgent location & hospital slips sharing

4. Address & Location Details

Address (House / Street / Road / Landmark) *

Village / Town / Ward *

Post Office (P.O.) *

Police Station *

District *

PIN *

5. Hospital Information

Name of the hospital where the patient is admitted *

Name and address of the hospital where blood is required for the patient *

6. Patient Photo *

Patient Photo *

Upload Patient Photo

JPG, PNG, WEBP (Photo of the patient)

I hereby declare that this blood requirement is genuine and urgently needed for the medical treatment of the mentioned patient. I authorize Udyam Social Development Foundation to broadcast this requirement to voluntary blood donors in our network.

Live Emergency Life-Saver Network

Verified Voluntary Blood Donors

The voluntary blood donors listed below have been officially verified and approved by the administration of Udyam Social Development Foundation. You can view their photo, blood group, contact details, and location for emergency blood assistance.

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Verified Donors Registry

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Donate Blood, Save Lives

Urgent Blood Requirement or Hospital Emergency?

Urgent Patient Blood Requirement Form

Verified Voluntary Blood Donors

Donor Name

Thank You, Blood Donor!

Emergency Request Registered