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Full Name
Gender
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Blood Group
O+ve
O-ve
B+ve
B-ve
A+ve
A-ve
AB+ve
AB-ve
A1+ve
A1-ve
A2+ve
A2-ve
A1B+ve
A1B-ve
A2B+ve
A2B-ve
Bombay Blood Group
Date Of birth (dd.mm.yyyy)
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District
SELECT DISTRICT
ERNAKULAM
ALAPPUZHA
IDUKKI
KANNUR
KASARAGOD
KOLLAM
KOTTAYAM
KOZHIKODE
MALAPPURAM
PALAKKAD
PATHANAMTHITTA
THIRUVANANTHAPURAM
THRISSUR
WAYANAD
Taluk
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Nearest Hospital(s)
Mobile Number
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Other No (if any)
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E -mail
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