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Authorization: - , To Use My Blood Donation Card With National Blood

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AUTHORIZATION

I, ____________________, of legal age, Filipino, single and a resident of


_________________________________________________________________, authorizing
__________________________, to use my Blood Donation Card with National Blood
Services/Philippine Red Cross for the transfusion of blood to his wife (______________).
Singed this 07th day of August, 2018 at Quezon City

__________________

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