Bangladesh     The Virtual Blood Bank                                                          www.rokto.org
                   Blood Donors                                 [ take the call. serve humanity ]

 

 

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Welcome to Registration
 
If you are willing to donate blood, please fill up the following form. Once you have filled up the form, you will become a member with us.

Your Name, Blood Group and Contact Details will be added to our database and will be available for viewing on our website. Someone who needs blood of your group will contact you and request you for blood.

Please be reasonably careful when someone contacts you for blood - get detailed information from the person requesting you to donate blood. Take his/her phone number, ask where the patient is, take the phone number of the clinic where the patient is. Take the name and phone number of the Doctor taking care of the patient. Call the clinic, talk to the doctor. If you are satisfied, leave the contact details of the person and clinic with your family and then go to the clinic/hospital to donate blood. You understand that we are just trying to help people to get blood from donors like you. It is not possible for us to do a security check on the person requesting you for blood. You have to ensure your security.
     
Full Name      
     
Date of Birth (DD/MM/YYYY) Day Month Year  
     
Occupation      

 
   
Blood Group  
   
Current Address
     
District    (Your district will be used for Donor Search. Please select the district where you are currently staying. Not the home district.)  
     
Thana/Area  
     
Phone    

Area Code   

 

              

     

Phone   

 
     
Mobile Phone  
     
email  
     
Create User ID          
     
Password (at least 6 characters)      Confirm Password  
     
Last Date of Blood Donation Day Month Year  
     
I have read the terms and conditions.