A new revolutionary technology product to the world for Complete Healths Care which lets them deliver an exceptional visit experience to patients, job seekers and many more
JEUTI EYE BANK, JORAHT
UNFORM DONOR PLEDGE
In the hope that I may help others, I hereby make this anatamic at gift, if medically acceptable to take effect upon my death, The words and marks below indicate my desires.
I give my eyes for the purpose of transplantation, medical research of education I further direct my next-of-kin herein named to execute this gift after my death.
INSTRUCTIONS
- Fill in the donor piedge card. Have your signature witnessed by two persons. (If you are not yet have your parent or guardian as one of the witnesses.
- Discuss your descision with your family members and friends. Get the signature of your next of kin. The pledge form is connsidered incomplete without the signature of the next of kin.
- Please send or mail the completed form to jeulti Eye Bank. K .k Handlque path,Jorhat,Assam, Pin: 7850010, Pin: 7851001, Ph: 1919
- We will send you in return the donor card stating your pledge.
- Please carry the donor card with you at all times. If you change your name or address, please inform the Jeuti Eye Bank.