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ARPAN EYE BANK

FAMILY PLEDGE CARD

We have pledge to donate our eyes after our deaths for the purpose of Corneal Transplantation, Research, or Medical Education. Donor Names:
1. 2. 3. 4. 5.

Signature:

ARPAN EYE BANK: 2, POONAM, 160 R.B. Mehta Road, Ghatkopar (E), Mumbai - 400 077. TEL.No.: 022-25016897, 022-25010861, 022-25011617 MOBILE: +91-9769129895 EMAIL: arpaneyebank@gmail.com

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