Have The Will To Pledge

Pledge Form

I
s/o, d/o, w/o shri
Age
Address
hereby unequivocally authorize the removal of my organ/organs from my body after my death for therapeutic purpose.

EyeSkinOrgan
Contact No:
Email id:
Relationship with donor:
Relative Name:
Contact No:
Email id:
Date:
Signature:

You Will Receive The Following

4-Fridge-Magnets

Fridge Magenet

Donor Card

3-Certificate

Donor Certificate