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