Address

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

Donor

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Receiving registration department(*)
Registration method
Transplant registration center

Personal information

Full name (*)
Date of birth (*)
Gender (*)
Permanent address (*)
Job
Place of work
ID card number/Passport number (*)
Date of issue (*)
Place of issue (*)

Medical record information

Height (cm)(*)
Weight (kg)(*)
Blood type
HLA
Hepatitis virus (*)
HIV
Diagnosis

Contact information

Phone number for contact (*)
Email (*)
Phone number of relatives(*)
Relationship to relatives(*)
Address (*)