Mercy Mission- Plasma Donors Drive
Mercy Mission is a group of 25+ NGOs working across Bengaluru to fight the COVID pandemic together.                          
As COVID-19 cases are increasing by every passing day, we at Mercy Mission are working to help these Covid-19 patients fight back & recover. This initiative is to identify DONORS OF PLASMA who have recovered from COVID-19 recently.

If you were infected by COVID-19 and have fully recovered and are from Bengaluru, we request you to please come forward and add your name to this list of potential donors. The data in this list will be kept confidential and we will get in touch with you when the matching requirement from a patient arises.
                            "SAVING ONE LIFE IS LIKE SAVING THE ENTIRE HUMANITY"
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Mercy Mission is a coalition of 25+ NGOs of Bengaluru joined to fight COVID
Do you wish to donate your Plasma? *
Your Complete Name *
Contact Number *
Your email ID
Age *
Gender
Clear selection
Your Blood Group *
Was your COVID-19 diagnosis confirmed by a lab test? *
Approximate Date you tested positive
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Date of discharge from Hospital or Date of completion of Home Quarantine period? *
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/
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Do you have a copy of your RT PCR test (Swab Test) that came positive? *
Has it been at least 14 days since the last day of your symptoms (COVID-19 symptoms include fever, cough and shortness of breath)? *
Do you currently have symptoms? *
Do you have a copy of your RT PCR test (Swab Test) that came negative within the last 14 days?"
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