Thyrocare Test Booking Form
Please Fill in the Form.
Thyrocare representative will call to schedule the test at your convenient time.
For Help or Queries regarding Tests or Prices, please call on +919550407878
Choose a Test (Prices are inclusive of Tax) *
For Packages price is All Inclusive (AI). For a single test sample preparation charges of Rs.100 will apply. For Multiple tests only once a charge of Rs.100 will be applied.
Required
Tests Required for How many People *
Enter 1,2,3,4, etc
Your answer
N-A-M-E, A-G-E, G-E-N-D-E-R of All the Persons undergoing Tests *
(Ex: RAJESH 31 MALE, SWATI 45 FEMALE. Separate each person details by commas)
Your answer
Date on which you like to have the Blood Sample Collected *
Example for 25th December write 12/25
MM
/
DD
FULL Address from where Test Sample has to be collected * *
Please enter Full Details such as House Number, Street Name, Locality, City, Etc
Your answer
Pincode * *
Your answer
Mobile Number of the Person who is booking the test * *
Thyrocare will call you on this number to confirm the booking.
Your answer
Email Id * *
Your answer
Other Specific Tests Details & Comments
Specific tests or which tests are required for whom, etc
Your answer
Hard Copy of Report Required? Rs.50 will be extra. * *
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