write this will to donate
my body after death as a gift to the Department of Anatomy, Faculty of Science, Mahidol
University for the use in medical education or research purposes. At the time I make this will, I
confirm that I am over 20 years of age and that this gift is being made voluntarily in a sound and
healthy state of mind. I hereby verify my understanding of all listed disclosures in the Body
Donation Information document and Body Donation Will for Medical Education form, with
adequate time for consideration.
I hereby notify and grant (name) _______________________