Offer Medicine

Tell us about the medicine you would like to donate. Our team will verify it before it reaches anyone in need.

1 Your Details Your Details

Your Name

Mobile Number

A 10-digit mobile number. Updates are sent here.

2 Address Location

Block

GP / Municipality

Area / Village

Detailed Address

3 What You Would Like to Give What You Are Offering

Medicine Name

Type

Quantity

Expiry Date

Manufacturer

Available From

Prescription Required

Description / Additional Details

Medicine Photo

Click to upload or drag and drop A clear photo of this medicine's strip, bottle or box. JPG, PNG or WEBP, up to 5 MB.

4 Details Additional Information

Description

Additional Remarks

I confirm the details above are true and I consent to being contacted by the MLA's Office about this submission.

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