[gtranslate] Stem Cell Donor Pre-Registration Form Name with Initials * Name in Full * Date of Birth * Gender *GenderMaleFemale NIC Number Passport Number Address * Phone 1 *0 / 10 Phone 20 / 10 Email Have you ever donated Whole Blood/Platelet before *YesNo Upload your picture Drag and Drop (or) Choose Files I 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
