Stem Cell Donor Pre-Registration Form​ Name with Initials *Name in Full *Date of Birth *Gender *GenderMaleFemaleNIC NumberPassport NumberAddress *Phone 1 *0 / 10Phone 20 / 10EmailHave you ever donated Whole Blood/Platelet before *YesNoUpload your pictureDrag and Drop (or) Choose FilesI sincerely pladge that, I have read and understoon everything mentioned above I wish to be enlisted as a stem cell donor in the SLSCDR and have no objection towards being contacted for further details and sampeling. In the event of a change of contact address/phone number, I will inform the SLSCDR as soon as possible (Email: slscdregistry@gmail.com). Above mentioned information is true and correct to my knowledge. I agreeI don’t agreeYou must agree to this to proceed as a Stem Cell Donor.Submit
