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PATIENT REGISTRATION FORM
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Client Name
*
KALRA DIAGNOSTIC LABORATORY
GURU KRIPA LAB SGNR
SMT LAJWANTI MEMORIAL HOSPITAL
SHRI SHYAM LABORATORY AND X RAY CENTER
GURUKRIPA DIAGNOSTIC LAB HMH
SHRI BHAGWATI LAB
GAURAV KUMAR
HOME COLLECTION SGNR
HOME COLLECTION ABOHAR
S K DIAGNOSTICS
BALA JI DIAGNOSTIC LAB
MAHARAJA LAB
STAR LAB
SHIV LAB SGNR
HEALTH CARE LAB
KAMAL ARORA
SHYAM SUNDER
AASHIRWAD LAB SGNR
MEDICITY
VIKRAM
SHRI UTTAM DIAGNOSTIC LAB
DASHMESH LAB
SATENDER
Client Mail ID
*
Barcode
*
Patient Mobile Number
*
Patient's Name
*
Gender
*
MALE
FEMALE
OTHER
Age
*
Test Name
*
PRELIMINARY HEALTH CHECK UP 400 MRP
ADVANCE HEALTH CHECK UP 500 MRP
AYUSHVAAN ROUTINE PACKAGE 6.2 1000 MRP
AYUSHVAAN ROUTINE PACKAGE 7.2 1300 MRP
AYUSHVAAN ROUTINE PACKAGE 5.2 MALE 2300 MRP
AYUSHVAAN ADVANCE PACKAGE 2 FEMALE 2300 MRP
ADVANCE HEALTH CHECK UP 2.0 549 RS MRP
HBA1C
Vitamin D Hydroxy
AMH / MIS, SERUM
THYROID PANEL II, SERUM
Abnormal HEMOGLOBIN Studyies, HB varient HPLC
PSA TOTAL, PROSTATE SPECIFIC ANTIGEN, SERUM
CA 125 (OVARIAN CANCER MONITOR), SERUM
HCG, SERUM
VITAMIN B12 LEVEL, SERUM
PROGESTERONE P4
THYROID PANEL, SERUM
TESTOSTERONE, Free
PARATHYROID HORMONE (INTACT), SERUM/PLASMA
TESTOSTERONE, TOTAL, SERUM
TSH 3RD GENERATION ULTRA( TSH3 - UL), SERUM
FOLLICLE STIMULATING HORMONE, SERUM
LUTEINIZING HORMONE, SERUM
PROLACTIN, SERUM
HLA-B27 Studies By PCR Method
QUADRUPLE MARKER, SERUM
CARDIOLIPIN ANTIBODIES, SERUM
Maternal Screen 1 Trimester,DOUBLE MARKER TEST,
INSULIN, FASTING SERUM
TISSUE TRANSGLUTAMINASE IGA, SERUM
Maternal Screen 2 Trimester, Triple MARKER TEST, SERUM
TORCH 10
CCP Anti cyclic citrullinated ANTIBODIES, SERUM
ANTI-PHOSPHOLIPID ANTIBODIES (IGG & IGM), SERUM
(ANA )ANTI-NUCLEAR ANTIBODY SCREENING, serum
Torch 8
CBC
Lipid Profile
Culture and Sensitivity, Blood
HBV DNA QUANTITATIVE VIRAL LOAD
HCV RNA QUANTITATIVE VIRAL LOAD
Iron Studies
E2 Female Reproductive Hormone
CRP ( C REACTIVE PROTINE ) QUANTITATIVE, Seum
RA TEST RHEUMATOID FACTOR QUANTITATIVE
OTHER TEST
Other Test Name
Last Meal Date
6-Jan-25
7-Jan-25
8-Jan-25
9-Jan-25
10-Jan-25
11-Jan-25
12-Jan-25
13-Jan-25
14-Jan-25
15-Jan-25
16-Jan-25
17-Jan-25
18-Jan-25
19-Jan-25
20-Jan-25
21-Jan-25
22-Jan-25
23-Jan-25
24-Jan-25
25-Jan-25
26-Jan-25
27-Jan-25
28-Jan-25
29-Jan-25
30-Jan-25
31-Jan-25
1-Feb-25
2-Feb-25
3-Feb-25
4-Feb-25
5-Feb-25
6-Feb-25
7-Feb-25
8-Feb-25
9-Feb-25
10-Feb-25
11-Feb-25
12-Feb-25
13-Feb-25
14-Feb-25
15-Feb-25
16-Feb-25
17-Feb-25
18-Feb-25
19-Feb-25
20-Feb-25
21-Feb-25
22-Feb-25
23-Feb-25
24-Feb-25
25-Feb-25
26-Feb-25
27-Feb-25
28-Feb-25
1-Mar-25
2-Mar-25
3-Mar-25
4-Mar-25
5-Mar-25
6-Mar-25
7-Mar-25
8-Mar-25
9-Mar-25
10-Mar-25
11-Mar-25
12-Mar-25
13-Mar-25
14-Mar-25
15-Mar-25
16-Mar-25
17-Mar-25
18-Mar-25
19-Mar-25
20-Mar-25
21-Mar-25
22-Mar-25
23-Mar-25
24-Mar-25
25-Mar-25
26-Mar-25
27-Mar-25
28-Mar-25
29-Mar-25
30-Mar-25
31-Mar-25
1-Apr-25
2-Apr-25
3-Apr-25
4-Apr-25
5-Apr-25
6-Apr-25
7-Apr-25
8-Apr-25
9-Apr-25
10-Apr-25
Last Meal Time
5:00 pm
6:00 pm
7:00 pm
8:00 pm
9:00 pm
10:00 pm
11:00 pm
12:00 am
1:00 am
PROCESSING LAB
*
DR LAL PATH LABS
AGILUS DIAGNOSTIC ( SRL )
HEALTHIANS
METROPOLIS HEALTHCARE
THYROCARE
REDCLIFFE LAB
VEERPATH LAB ALLERGY
JERATHPATH LAB ALLERGY
ENDOCRINE LAB
MAX HEALTHCARE
PATHKIND
RELIABLE DIAGNOSTICS
RELIABLE DIAGNOSTICS RGHS
APOLLO DIAGNOSTICS
TATA 1 MG
NEUBERG DIAGNOSTIC
CLINOVA
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customercare@hflab.in
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78 Saroj Kund, Eros Garden, Faridabad
76-888-555-40
Timing: 5am -8pm
