up for donating your Eyes
In order to sign up as
an eye donor, Please print out the following form and fill it in &
send by mail to the In-charge Eye Bank, Department
Of Ophthalmology, Sri Guru Ram Das Charitable Hospital, O/S
Chatiwind Gate, Amritsar - 143006 (Punjab) or Rotary Eye Bank, Dr.
Daljit Singh Eye Hospital, Mall Road, Amritsar-143001(Punjab).
Alternatively, fill in this form.
When you do so, an email will be sent to the Eye Bank
who will mail you a form that you can fill in and return
If you face any difficulty
in filling out or submitting this form, please email
with the relevant details.
I hereby bequeath
to donate my eyes
after my death to the Guru Ram Das Eye Bank/ Rotary
I solemnly affirm that the
above is binding on my next of kin / heir
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