PUNJAB PHARMACY COUNCIL, LAHORE

(Established under Pharmacy Act, 1967)

Block No.7, LDA Flats, Huma Block, Allama Iqbal Town, Lahore. Ph. # 042-99260298-300
www.punjabpharmacycouncil.com

Attested
Photograph
to be Pasted
To by the
The Secretary Applicant
Punjab Pharmacy Council, Lahore

Application Form for Registration as Pharmacy Assistant in Register-B

I hereby submit that I appeared in the examination of Pharmacy Assistant conducted
by Punjab Pharmacy Council under section 29 of Pharmacy Act, 1967 amended in
1973 held in under Roll No. and
was declare successful. I therefore, apply for Registration Pharmacy Assistant in
Register-B of Punjab Pharmacy Council.
My particulars are as follows:-
1. Name (Block Letters)
2. Father’s Name:
3. Permanent Address:

4. Postal Address:

5. Enrollment Certificate No.

6. Date of Birth Place of Birth
7. National Identity Card No. Nationality
8. e-mail address. Phone No.
9. Mark of Identification
10.The prescribed Fee of Rs. has been remitted by
Bank Draft/Pay Order No. _ Dated:
Receipt No. Dated:
Signature of Applicant

Dated: English

Urdu

Following documents must be submitted/attached with the application form:

1. Four (4) attested colored photocopies of Matric Certificate or Dispenser Certificate.
2. Six (6) Attested photographs Passport Size (blue background & clear photo) (one attest from front
side & 5 attested back side attested photographs).
3. One (1) Photocopy of Result Card issued by Punjab Pharmacy Council.
4. Two (2) Photocopies of National Identity Card attested
5. Three (3) Attested Specimen Signatures. (signed with black marker)
6. Fee for Matric or equivalent certificate or Dispenser Certificate issued by Punjab Medical Faculty
verification as prescribed / required by the Board concerned.
7. An affidavit attested from Oath Commissioner / Notary Public/ Magistrate 1st Class on Non–Judicial
paper of Rs. 100/- indicating specimen overleaf.
8. In case, candidate is unable to appear personally in office Punjab Pharmacy Council, for registration,
he/she will submit valid justification along with authority letter to the concerned person and valid NADRA
biometric verification from any centre.
9. Pay Order / Demand Draft Registration Fee in the name of Secretary, Punjab Pharmacy Council of Rs.
5000/- or Registration Fee may be submitted in the office of Punjab Pharmacy Council personally.
 AFFIDAVIT
I, S/o
Caste Resident of
Tehsil District do hereby
solemnly affirm and declare as under:-
1. I have passed Secondary School Certificate with Roll No. __________ year _________
certificate no._________________, is genuine.
2. I passed dispenser examination from Punjab Medical Faculty in which my Roll No. ______
passing year __________ certificate no. ____________ is genuine.
OR
If the candidate applied through apprenticeship the Sr. no. 2 will be
3. I got apprenticeship certificate issued by__________ working as _______________. My
apprenticeship no. __________ dated _________.
4. I passed Pharmacy Assistant, Examination in the Year_____________
Month________ Roll No. _______Enrollment No. is __________.
5. That my National Identity Card No._____________ is genuine.
6. That I have never been granted Registration Certificate by any of the Provincial Pharmacy
Council in Pakistan. Neither, I, have applied for the same elsewhere.
7. That I have never been convicted by any Court of Law for an offence involving Moral
Turpitude.
8. That I have never been declared unsound mind by any Court of Law.
9. That in case of false information Punjab Pharmacy Council may take action against me as
per law.
10.That as stated above is true to the best of my knowledge and belief.

VERIFICATION DEPONENT

Verified on oath this

Day of _ at
That the contents of this affidavit are true to the best of my
Knowledge and belief and nothing have been concealed.

DEPONENT
 Punjab Pharmacy Council, Lahore
Specialized Health Care & Medical Education Department
Government of the Punjab
(Established under Pharmacy Act, 1967)

Ref. No. _______________ Date: ______________

To
Name of Applicant ______________________________________________
Address ______________________________________________
______________________________________________
Subject: DOCUMENTRY DEFFICIENCY IN YOUR APPLICATION FOR REGISTRATION AS
PHARMACY ASSISTANT IN REGISTER-B

Reference your application for Registration as Pharmacy Assistant in Register-B in Punjab Pharmacy
Council, Lahore, on preliminary scrutiny of your application by the One Window Cell following documents
were found deficient / not as per format:

S# Requirement as per Volume 1.1 Attached Not As per Not as per

Attached format format
1 Four (4) attested colored photocopies of Matric Certificate or
Dispenser Certificate.
2 Six (6) Attested photographs Passport Size (blue
background & clear photo) (one attest from front side & 5
attested back side attested photographs).
3 One (1) Photocopy of Result Card issued by Punjab
Pharmacy Council.
4 Two (2) Photocopies of National Identity Card attested
5 Three (3) Attested Specimen Signatures.
(signed with black marker)
6 Fee for Matric or equivalent certificate or Dispenser
Certificate issued by Punjab Medical Faculty verification as
prescribed / required by the Board concerned.
7 An affidavit attested from Oath Commissioner / Notary Public/
Magistrate 1st Class on Non–Judicial paper of Rs. 100/-
indicating specimen overleaf.
8 In case, candidate is unable to appear personally in office
Punjab Pharmacy Council, for registration, he/she will submit
valid justification along with authority letter to the concerned
person and valid NADRA biometric verification from any
centre.
9 Pay Order / Demand Draft Registration Fee in the name of
Secretary, Punjab Pharmacy Council of Rs. 5000/- or
Registration Fee may be submitted in the office of Punjab
Pharmacy Council personally.

*  Tick the in the relevant box.

** The candidate may proceed for Registration fee submission.
*** Fee as per Sr. No. 6 is the responsibility of applicant and less fee submission will delay the process of
registration.
**** Candidate before submission of documents shall check all the documents to avoid un-necessary
delay
***** The applicant is required to furnish deficient documents along with this letter at the earliest to
proceed further.

________________ ____________
Signature & Thumb PPC Staff
(Candidate) Counter No. 3

Block No. 7, LDA Flats Huma Block, Allama Iqbal Town, Lahore. Ph: 042-99260298 & 300
Website: www.punjabpharmacycouncil.com
Email: [email protected]