Take the Organ Pledge | Karma Samaj Foundation

You are about to take one of the most meaningful decisions of your life.
- It costs nothing.
- It takes just 5 minutes.
- It could save up to 8 lives.

Fill this form honestly and completely. We will handle everything else.

Section A — Personal Details

Full Name *

Gender *

Date of Birth *

Blood Group

Aadhaar — Last 4 Digits Links to NOTTO national registry

PAN Number

Mobile Number *

WhatsApp on this number

Email Address *

Address Line 1 *

Address Line 2

State *

City *

PIN Code *

Section B — Organs to Donate

You may select all or choose specific ones. Any pledge is a profound act of generosity.

✅ All of the above — I wish to donate all organs and tissues

Section C — Emergency Contact

Your emergency contact is the person who will be informed of your pledge — and who should be aware of your decision when the time comes.

Emergency Contact Name *

Relationship *

Emergency Contact Mobile *

Emergency Contact Email

Has your emergency contact been informed of this pledge? *

Yes — they know

Not yet — I will tell them

I prefer not to share with them now

Section D — Declaration & Consent

I hereby voluntarily pledge to donate the organs and tissues selected above upon my death. I understand that this pledge does not override my family's consent at the time of donation, and I commit to informing my family of this decision. *

I consent to Karma Samaj Foundation submitting this pledge to AIIMS or any other agency like NOTTO / SOTTO Delhi for official registration. *

I consent to Karma Samaj Foundation issuing a pledge certificate in my name. *

I agree to receive updates about my pledge status via email, SMS, and WhatsApp. *

I have read and agree to Karma Samaj Foundation's Privacy Policy. *

I declare that I am 18 years of age or above. *

One Pledge. Up to 8 Lives.

Lives saved

Helped via tissue

Time to pledge

₹0

Cost

This is the moment. Just 5 minutes from now, you can complete your organ donation pledge.

Section A — Personal Details

Section B — Organs to Donate

Section C — Emergency Contact

Section D — Declaration & Consent

One Pledge. Up to 8 Lives.

Not sure yet?