Address

72 Đường Nguyễn Chí Thanh, Láng Thượng, Đống Đa, Hà Nội

Donor

Register for corneal donation

Surgeon information

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Phone (*)
Transplant registration center *

Surgery information

Surgery location (*)
Address (*)
Surgery date (*)
Surgery time (*)

Patient information

Full name (*)
Date of birth (*)
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Nationality (*)
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Job
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ID card number/Passport number (*)
Date of issue (*)
Place of issue (*)

Disease information

Hepatitis virus (*)
HIV
Diagnosis

Contact information

Corneal (*)
Sclera (*)
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Contact information

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