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MBBS Admission Form - UHS Lahore

This document is an admission form for Hafiz Naveed Ul Hassan Sajid to appear for the 3rd Year MBBS annual examination in 2019. It provides his personal details like name, father's name, CNIC number, mailing address and contact information. It also lists the subjects he must appear in to pass the professional examination. The form is certified by the Head of his institution, Sahiwal Medical College, confirming his eligibility as per rules to take the exam.

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109 views2 pages

MBBS Admission Form - UHS Lahore

This document is an admission form for Hafiz Naveed Ul Hassan Sajid to appear for the 3rd Year MBBS annual examination in 2019. It provides his personal details like name, father's name, CNIC number, mailing address and contact information. It also lists the subjects he must appear in to pass the professional examination. The form is certified by the Head of his institution, Sahiwal Medical College, confirming his eligibility as per rules to take the exam.

Uploaded by

naveed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form No: 168249

UNIVERSITY OF HEALTH SCIENCES, LAHORE


Khayaban-e-Jamia Punjab, Lahore. Phone(Off) 042-99230395 (6 Lines,) Ext. 321

ADMISSION FORM

MBBS

NOTE:
* Form MUST be filled by the candidate ONLY.
* Form with incomplete/incorrect information will be rejected.

1 Admission form for: 3rd Year: Third Professional (Annual - 2019)

2 Full Name(first,middle,last)

HAFIZ NAVEED UL HASSAN SAJID


3 Father Name(first,middle,last)

ALLAH DITTA SAJID


4 Applicant CNIC No./B-Form No.

3530189007061
5 Name of Institution

Sahiwal Medical College,Sahiwal


6 Registration No.

2016-SHMC-0071-UHS Nationality : Pakistani


7 Mailing Address (Mention all relevant information with postal code)

Mouza mancharian tehsil depalpur,District Okara

8 Mobile Phone No. 03120744755 Email/Fax No. [email protected]

9 Parent/ Guardian Mobile Phone No. 03007951366 Landline No. (with City code) 0000000000

10 Status: 1st Attempt

Last Exam Attempted in: Urology Exam Type: Annual


Roll No: 23546 Year : 2018
11 Subject in which a candidate MUST appear to pass the said professional Examination

1 : Pharmacology & Therapeutics


2 : General Pathology & Microbiology
3 : Behavioural Sciences
4 : Forensic Medicine & Toxicology

Page 1 of 2
Form No: 168249

UNIVERSITY OF HEALTH SCIENCES, LAHORE


Khayaban-e-Jamia Punjab, Lahore. Phone(Off) 042-99230395 (6 Lines,) Ext. 321

ADMISSION FORM

MBBS

12 Fee Paid (Pakistani Rupee) 5770 Payment Mode: Bank Draft


:
Draft/Payorder/Bank deposit Receipt No. 0123 Date : 05-Sep-2019
13 Documents to be attached :
Attested copies of the following documents are submitted with the HARD COPY of the Online Admission Form duly Endorsed by the Head of the Institution.

HSSC/Equivalence Certificate Detailed Marks Certificates (DMCs) of Migration Certificate PM & DC Registration Certificate
(Only for candidate taking 1st previous Professional Exams.
Professional Examination)

STUDENT DECLARATION

I hereby solemnly declare that :


(1) the information provided by me in this form is correct and no information has been concealed.
(2) I shall be responsible if my application form is rejected on the basis of any error, misinformation and omission.
(3) I understand that taking examination without being fully eligible is a crime under law, and in such case, the University will cancel the
result.

Date : Signature:
Signature of Applicant

HEAD OF INSTITUTION CERTIFICATION


I certify that the candidate is eligible as per Rules & Regulations of PM & DC and University of Health Sciences , Lahore to take the above
mentioned examination.

Date : Signature:
Signature of Head of Institute
(with stamp)

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