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KING FAHAD MEDICAL CITY
TRANSFUSION MEDICINE SERVICE / BLOOD BANK
BLOOD DONATION REQUEST FORM FOR SURGERY/OTHER PROCEDURES REQUIRING BLOOD
Patient Name:*  
Medical Record Number:*  
Age:  
Gender:
Email:*
Reason for Donation:

Booking Date of the Procedure: *
Select a date from the calendar.
 

 
Number of donors required and Type of Donation:


  Others (specify) 
 


  Others (specify) 
 


Instructions for Blood Donor
  • Relatives/friends of the patient are requested to bring the required number of donor’s prior to elective surgery/ procedure described above.
  • In the event that relatives/friends are not able to provide the required number of donors, scheduled procedure may be postponed.
  • Blood Bank Donation Timing: from Saturday to Wednesday 8:00am until 5:00pm except during month of Ramadan timing will be from 6:00pm to 2:00am.
  • Requirements for registration of donor:
    • National ID, IQAMA, or Driver’s License
    • Age: 18 yrs to 65 yrs
    • Weight: 50kg and above
    • Enough sleep before donation (6-8 hours)
    • Healthy Individual (not on regular medication)
  • Type of donation: whether Whole Blood or Platelet pheresis will depend on the size of the vein as determined by the blood bank staff and complete blood count result.  




 
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