Donation Form – Balrampur Hospital Foundation

£ Donation Amount:

Select Payment Method

Offline Donation
PayPal

Personal Info

First Name *

Last Name

Email Address *

To make an offline donation toward this cause, follow these steps::

Write a check payable to "Balrampur Hospital Foundation"
On the memo line of the check, indicate that the donation is for "Balrampur Hospital Foundation"
Mail your check to:

Balrampur Hospital Foundation
2 Wheatley Close,
Hornchurch, RM11 2DR,
United Kingdom

Your tax-deductible donation is greatly appreciated!

Donation Total: £100.00