π©Έ Question 1/8
Basic Info
What is your age?
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π©Έ Question 2/8
Basic Info
What is your weight in kilograms?
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π©Έ Question 3/8
Health Status
Are you feeling healthy today? (No cold, fever, cough, or other acute symptoms)
π Healthy, no symptoms
π€ Have cold/fever/symptoms
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π©Έ Question 4/8
Health Status
Have you had any surgery, blood transfusion, tattoo, or piercing in the last 6 months?
β None of these
β
Yes, one or more
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π©Έ Question 5/8
Medical History
Do you have any of the following conditions? (Heart disease, uncontrolled hypertension, hepatitis, HIV, epilepsy, cancer, etc.)
π’ None of the above
π΄ I have one or more
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π©Έ Question 6/8
Medications
Have you recently taken antibiotics or blood thinners (such as aspirin, warfarin)?
π Not taking these
π Currently taking
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π©Έ Question 7/8
Travel History
Have you traveled to a malaria-endemic area in the last 12 months? (e.g., parts of Africa, Southeast Asia)
π No, I haven't
βοΈ Yes, I have
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π©Έ Question 8/8
Lifestyle
Recent donation history?
π
Never donated or over 3 months ago
π©Έ Donated within last 3 months
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