COVID-19 Information Portal
Government of Odisha
Registration of Plasma Donors
Anyone who wants to donate plasma is required to register by filling up the form.
Name
*
Age
*
Gender
*
--Select Gender--
Male
Female
Other
Pregnancy History
*
Yes
No
Date of Diagnosis
*
Date of Discharge
Hospital Treated with Reg No
Positive Confirmation Report Date
*
Negative Confirmation Report Date/Date of Complete Recovery
Mobile No
*
Brief Clinical History
*
District
*
--Select District--
Angul
Balasore
Bargarh
Bhadrak
Bolangir
Boudh
Cuttack
Deogarh
Dhenkanal
Gajapati
Ganjam
Jagatsinghapur
Jajapur
Jharsuguda
Kalahandi
Kandhamal
Kendrapara
Kendujhar
Khordha
Koraput
Malkangiri
Mayurbhanj
Nabarangpur
Nayagarh
Nuapada
Puri
Rayagada
Sambalpur
Subarnapur
Sundargarh
Block
City
*
Address
*
Informed Consent
*
Yes
No
Upload Covid Positive Report
(Upload only .doc,.docx,.pdf,.jpg & .jpeg extension files)
Select Plasma Bank
*
--Select Plasma bank--
SCB Hospital
IGH Rourkela
MKCG Medical College Berhampur
Capital Hospital
VIMSAR, BURLA
SLN Medical College and hospital, Koraput
Please enter the OTP sent to your registered mobile no
*