Give so that others may live...
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Donor Registry
What is your blood type
A+
A-
B+
B-
O+
O-
AB+
AB-
Don't know
Have you donated blood already?
yes
no
Do you like to be a member of a Blood Donor's Club?
Yes
No
Personal Information
First name
Age
Last name
Sex
Street address
Status
City
Weight(kgs)
State/Province
Zip/Postal Code
Country
Phone
E-mail