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Fillable Printable Generic Eye Donation Form

Fillable Printable Generic Eye Donation Form

Generic Eye Donation Form

Generic Eye Donation Form

EYE DONATION FORM
Please fill up the space and give it to your next of kin. You can also give a copy to the nearest
eye bank.
Full Name & Full Address:
-
Telephone Number
TO WHOMSOEVER IT MAY CONCERN
In the hope that I may help others, I hereby make this gift to be effective upon my death.
I declare my desire for eye donation after my death. Hence I sincerely request my close
relatives, friends and well wishers to
contact and call the nearest available eye bank in the
event of my death, as quickly as possible.
Signature
Name:
Place:
Date:
Important Eye banks in Delhi:
Guru Nanak Eye Centre
23234612
National Eye Bank (AIIMS)
22651123;26864851
-
59
AIIMS(Eme
rgency)
26569461
Rotary Delhi Centre Eye Bank, Sir Ganga Ram Hospital
25781837, 25721800
Apollo Eye Bank
26925858
A-
Edward Maumenee
-
Eye Bank(A Unit of Venu charitable Society)
26291951
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