We need every monetary assistance you can give us. Please fill the form below and mail it with your cheque/demand draft payable in Mumbai to Tata Memorial Centre for BTF. The completed form should be mailed to the following address: Brain Tumour Foundation, Room No.189 B, Golden Jublee Blgd.Tata Memorial Hospital, Parel, Mumbai. 400 012. India
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Date: (dd/mm/yy)

I / We wish to donate a sum of

In words:

Cheque / Demand Draft Number:
Payable to 'Tata Memorial Centre' for BTF.
Drawn on Bank:

100% Tax Exemption u/s 35 (i) ii wanted:

Signature____________________________

Name:

Address where the receipt should be mailed:

Phone:

Fax No:

Email:


You wish to donate on a yearly basis?
Would you like to receive regular activity reports of BTF?