A 40 year old female was admitted for dysfunctional uterine bleeding with low hemoglobin level ( Hb-5 . 2 g m / d l ) i n V i n a y a k a M i s s i o n s Kirupanandha Variyar Medical College and Hospitals. In view of her clinical profile the decision was made to transfuse packed red blood cells. Both anemia and blood transfusion practice is not without patient risk and adverse events1.