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Emergency Call +8801621023828
MEDICALL BD · Blood Request

Blood Receiver Registration Form

Need blood for a patient? Provide the details below — we will quickly find a suitable donor and notify you. For emergencies, select "Emergency" for priority assistance.

Avg. response time 30 mins
Verified Donor Network
Emergency Hotline: +8801621023828

Patient Information

Provide details of the person who needs blood

Hospital Information

Where the blood needs to be delivered

Contact Information

Provide details of the patient's attendant

Prescription & Payment

Attach prescription for faster verification

Attach prescription as PDF or Image

No file selected yet
A travel allowance / honorarium of ৳200 must be paid now via bKash, Nagad, Rocket or Bank Transfer to submit this request — this covers the donor's travel costs. Enter the transaction details below after sending payment.

After submission, our team will verify and quickly match a donor

BLOOD NEED PROFILE
EMERGENCY
Request ID: Assigned after submission
Patient Name
Blood Group--
Bags Needed1 Bag
HospitalHospital Name
Date NeededNot selected
Travel Allowance (Pay Now) ৳200
1
Pending
2
Matched
3
Completed
Current Status
Pending
Contact
--
The ticket on the right will update live as you fill the form. After submission, the status will change from "Pending" to "Matched" when a donor is found, and to "Completed" once the donation is finished.