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Blood Donation – Canada

Title MrMrsMsMissDr First Name: Sur name: DOB: Post Code : House number : Address: Town/City: County: Email: DaytimeTel: EveningTel: Ethnicity :Sikh-----------------------------White- BritishWhite- IrishWhite - Any other White Background-----------------------------Mixed- White/Black CaribbeanMixed- White/Black AfricanMixed- White and AsianMixed- Any other Mixed background-----------------------------Asian- IndianAsian-…

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