From Old School RuneScape Wiki
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This item cannot be obtained legitimately.
Blood tithe pouch can only be acquired through illegitimate means. The Old School RuneScape Wiki does not condone rule-breaking actions.
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The blood tithe pouch is an item served by a vyrewatch to Vanescula Drakan and Ranis Drakan during a cutscene in Darkness of Hallowvale. It is not possible to obtain the item in-game.
Vanescula and Ranis Drakan being served a blood tithe pouch by a vyrewatch.
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