National Blood Center

Bonifacio Drive, Port Area, Manila

528-1164 / 527-0861
www.redcross.org.ph

Name: _________________________________________________________________________________________

Address: ______________________________________________________________________________________

_________________________________________________________________________________________________

Blood Type: __________________________________ Age: __________________________________________

Telephone Number: __________________________E mail Address: _____________________________

__________________________________
Signature

___________________________ _____________________________________
Date of pledge Place where pledge was made

I will donate on ___________________________________

(Kindly bring this portion when you donate blood.)

National Blood Center

Bonifacio Drive, Port Area, Manila
528-1164 / 527-0861
www.redcross.org.ph

You have the most precious gift of all, the ability to save lives!
Please give blood!
I will donate on _____________________.
“I am a blood donor, and I save lives!