hi, bleeding simultaneously from nose n mouth can be due to many causes..basically it is a problem in the blood cells.. the various causes are- 1.Pre-leukemia (myelodysplastic syndrome) Myelodysplastic syndromes are diseases that affect the bone marrow and blood, causing anemia and tiredness. 2.Thrombocytopenia Thrombocytopenia causes bruising, frequent nosebleeds, and tiny red dots that look like a rash. 3.Hemophilia Hemophilia is a disorder in which the blood lacks certain clotting factors making bleeding difficult to stop. 4.Anemia, aplastic Aplastic anemia is a lack of blood cells causing symptoms including weakness, shortness of breath and fatigue. i would suggest a basic complete blood panel to know the levels of different blood cells to pinpoint the cause...also since your friend is taking regular blood transfusions,the treatment is already underway.. thank you for your query