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A teacup containing a tea bag sits on a form titled "Donor Questionnaire" in Russian. The questionnaire seeks honest answers to questions related to blood donation and patient safety, including personal details like name, date of birth, and mobile number, as well as health-related questions about drug use, medical procedures, and contact with sick individuals. The form contains columns for "yes" and "no" answers. The location appears to be in an office setting, possibly in Astana, Kazakhstan, based on the language of the form. The teacup is in the foreground, slightly obscuring parts of the document.
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