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 Sign 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 to them.

If you face any difficulty in filling out or submitting this form, please email 
 bsdhillon@healthyeye.org  with the relevant details.


I hereby bequeath to donate my eyes after my death to the Guru Ram Das Eye Bank/ Rotary Eye Bank.

I solemnly affirm that the above is binding on my next of kin / heir

      Date & Signature


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