National Health and Education Society Regn No F-452 (BOM) under Bombay Public Trust Act, 1950 PAN AAATN0093Q   Income Tax Exemption Certificate No DIT(E)/MC/80G/1492/2009-2010 dated 21st April 2009 Valid from 1-4-2009 to 31-03-2012 u/s 80G of Income Tax Act, 1961   Regn No 083780269 under Foreign Contributions (Regulations) Act, 1976

Money donated by you will be utilized to treat poor patients who do not have the resources to bear the cost of treatment. The funds collected will be utilized for treatment at Hinduja Hospital only, at present. The details of utilisation of funds will be displayed on this website every year. Donations made to this fund are exempt from tax under 80G.

Title* : --Select-- Mr Ms Mrs First Name* : Last Name* : Date of Birth* : --Date-- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 --Month-- January February March April May June July August September Octomber November December --Year-- 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Address* : Country* : --Select-- Andorra United Arab Emirates Afghanistan Antigua and Barbuda Anguilla Albania Armenia Netherlands Antilles Angola Antarctica Argentina American Samoa Austria Australia Aruba Azerbaijan Bosnia and Herzegovina Barbados Bangladesh Belgium Burkina Faso Bulgaria Bahrain Burundi Benin Bermuda Brunei Darussalam Bolivia Brazil The Bahamas Bhutan Bouvet Island Botswana Belarus Belize Canada Cocos (Keeling) Islands Congo, Democratic Republic of the Central African Republic Congo, Republic of the Switzerland Cote d'Ivoire Cook Islands Chile Cameroon China Colombia Costa Rica Cuba Cape Verde Christmas Island Cyprus Czech Republic Germany Djibouti Denmark Dominica Dominican Republic Algeria Ecuador Estonia Egypt Western Sahara Eritrea Spain Ethiopia Finland Fiji Falkland Islands (Islas Malvinas) Micronesia, Federated States of Faroe Islands France France, Metropolitan Gabon Grenada Georgia French Guiana Guernsey Ghana Gibraltar Greenland The Gambia Guinea Guadeloupe Equatorial Guinea Greece Guatemala Guam Guinea-Bissau Guyana Hong Kong (SAR) Heard Island and McDonald Islands Honduras Croatia Haiti Hungary Indonesia Ireland Israel Man, Isle of India British Indian Ocean Territory Iraq Iran Iceland Italy Jersey Jamaica Jordan Japan Kenya Kyrgyzstan Cambodia Kiribati Comoros Saint Kitts and Nevis Korea, North Korea, South Kuwait Cayman Islands Kazakhstan Laos Lebanon Saint Lucia Liechtenstein Sri Lanka Liberia Lesotho Lithuania Luxembourg Latvia Libya Morocco Monaco Moldova Madagascar Marshall Islands Mali Burma Mongolia Macao Northern Mariana Islands Martinique Mauritania Montserrat Malta Mauritius Maldives Malawi Mexico Malaysia Mozambique Namibia New Caledonia Niger Norfolk Island Nigeria Nicaragua Netherlands Norway Nepal Nauru Niue New Zealand Oman Panama Peru French Polynesia Papua New Guinea Philippines Pakistan Poland Saint Pierre and Miquelon Pitcairn Islands Puerto Rico Palestinian Territory, Occupied Portugal Palau Paraguay Qatar R?nion Romania Russia Rwanda Saudi Arabia Solomon Islands Seychelles Sudan Sweden Singapore Saint Helena Slovenia Svalbard Slovakia Sierra Leone San Marino Senegal Somalia Suriname S? Tom·and Pr?cipe El Salvador Syria Swaziland Turks and Caicos Islands Chad French Southern and Antarctic Lands Togo Thailand Tajikistan Tokelau Turkmenistan Tunisia Tonga East Timor Turkey Trinidad and Tobago Tuvalu Taiwan Tanzania Ukraine Uganda United Kingdom United States Uruguay Uzbekistan Holy See (Vatican City) Saint Vincent and the Grenadines Venezuela British Virgin Islands Virgin Islands Vietnam Vanuatu Wallis and Futuna Samoa Yemen Mayotte Yugoslavia South Africa Zambia Zimbabwe State* : City* : Zip code * : Phone No # : Mobile No # : Email * : Nationality * : Donation for * : --Select-- Cancer Eye Surgery corneal/ cataract/ retina Ear (Cochlear Implant) Long Staying ICU Patients Long staying children in PICU Cardiac Surgery/ Stent Hip/ Knee Replacement Neuro Surgery Pediatric Neuro Surgery Pediatric Cardiac Surgery Spine/ Implant Cost Extensive Procedures and Investigations Physiotherapy Kidney Rural Health - Serve with Passion Other Amount of my donation* :