Blood Requisition Form


Blood Requisition Form

Blood Requisition Form

Although our Blood Bank is primarily set up to meet the requirements of in-patients, we also cater to the needs of patients admitted to other hospitals and nursing homes. This includes whole blood as well as blood components.

Such patients or their relatives are advised to contact us at on Tel: 022-62670300 for queries regarding availability of blood / blood components and modalities for the issue of blood units.

You need to furnish the following

* A written request from a doctor (MBBS / MD) / hospital stating the patient’s name / hospital identification number and specific requirements. Kindly ensure that the patient’s name / patient’s registration and ward or bed number are clearly mentioned. Details must be furnished on a letterhead.

* Patient’s blood sample in EDTA & plain bulbs. Make sure the sample is legibly and correctly tagged with his / her complete name

* Patients pay a service charge for the product.

The sample is then tested and the patient’s blood is matched. The test, called Cross-Matching, takes approximately 2 hours. It is only when a match is made that blood or components are released to patients who require transfusion.

Charges are levied for testing and materials used. Individuals who hold Voluntary Donor Cards are entitled to discounted rates.

You also need to fill out a requisition form, which is available at our Blood Bank. You may also download the form, duly fill it out and submit it to our Blood Bank. Blood and blood products are handed over to relatives of patients in specially designed carry bags with or without ice as required.

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