PATTABHI AGRO FOODS

Blood Donation Camp

Date: 12-10-2026

Give Blood - Save Lives

0 Registered Today

Donor Registration Form

Please enter your exact workplace details as requested below.

Reception Desk Mode

EMP CODE *

Please provide your employee code.

NAME *

Please enter your full name.

DEPARTMENT *

Please select or enter your department.

MOBILE NO *

Please enter a valid 10-digit contact number.

BLOOD GROUP * (Tap to select)

A+ A- B+ B- O+ O- AB+ AB- ❓ Not Sure / Don't Know

Please select your blood group.

I confirm that I am aged 18-65, weigh over 45 kg, and feel healthy to donate today.

Registered Donors (Admin Only)

Sheet Disconnected

Google Sheet Web App URL is not configured yet. Submissions are stored locally.

TOKEN	EMP CODE	NAME	DEPARTMENT	MOBILE NO	BLOOD GROUP	STATUS	ACTION
No donors recorded yet.

✓

Donor Registration Confirmed!

Registration confirmed successfully.

DONOR PASS

PATTABHI AGRO FOODS - BLOOD DONATION CAMP Date: 12-10-2026

BD-001

EMP CODE: ---

NAME: ---

DEPARTMENT: ---

MOBILE: ---

            BLOOD GROUP:
            ---
          

Please present this token at the screening desk.

Camp Mobile Registration QR

Display or print this QR code at your camp reception. Donors can scan it with their phone camera to fill out this exact form directly!

Admin Access Required

Pattabhi Agro Foods

Google Sheet integration settings are restricted. Please enter the Admin PIN to continue.

Enter Admin PIN:

Incorrect Admin PIN. Please try again.

ADMIN

Google Sheet Integration

Connect your form to your Google Sheet by entering your deployed Google Apps Script Web App URL:

Google Apps Script Web App URL: Follow instructions in google-apps-script.js or README.md to generate this URL.

Quick 3-step setup:

Open your Google Sheet > Extensions > Apps Script.
Paste the code from google-apps-script.js.
Click Deploy > New deployment > Web app (Set 'Who has access' to Anyone) > Copy URL.

Admin Security PIN

⏱️ Security Auto-Lock: Automatically locks after 2 minutes of idle time.

Pattabhi Agro Foods • Blood Donation Camp • 12-10-2026