The following feedback takes less than 10 minutes, and will greatly assist KPBD to help you better in upcoming events.
Your Name
Your Email
Your Mobile Number
Your Gender MaleFemale
Your Blood Group (Required) A+A-B+B-AB+AB-O+O-Don't Know
Your Age (Required) ---18-2425-3435-4445-5455-6465+
Have you ever donated blood? (Required) YesNo
If yes, how many times within the last 2 years? If no, proceed to next question.
What prompted you to donate blood? (Required) Emergency call for blood donationTo ensure that blood would be there if you or a loved one ever neededCommunity support
Other (please specify)
On a scale of 1-5 where 1 = "Completely Disliked" and 5 = "Completely Liked", please indicate your level of Dislike or Like with the following statement.
Do you satisfy from KPBD YesNo
In either case please specify
KPBD Reception 12345
KPBD Registration 12345
Blood Bank Reception 12345
Blood Bank Registration 12345
KPBD Form Filling Support 12345
KPBD Doctors Room Support 12345
KPBD Donation Room Support 12345
Certificate Distribution 12345
Food 12345
Water and Juice 12345
Media 12345
Do you have any comments-concerns you would like to share with KPBD?
KPBD contact with me whenever there is any blood donation appeal YesNo