Register as an Organ Donor

Your decision to donate can save multiple lives. Fill out the form below to pledge your organs.

Full Name

Date of Birth

Gender

Blood Group

Mobile Number

Address

State

Pin Code

Organs You Wish to Donate

Eyes

Heart

Kidneys

Liver

Lungs

Skin

Name

Relation

Phone

I hereby pledge to donate my organs and authorize Abhi Charitable Foundation to maintain this record.