Punjab Medical Faculty 62/A - D, New Muslim Town, Wahdat Road, Lahore

Examination Application Form

Paste one passport size coloured photograph without attestation

Official Use for Diary Section PMF Diary No. ________________ Date ________________________

Old Scheme

Official Use for Examination Section Roll No. ______________________ No. of Attempts _______________

New Scheme 1st Year 2nd Year

* Candidate of new scheme appearing in 2nd year exam but failed in 1st year, will have to submit separate exam forms for 1st year & 2nd year

Category

Session

Challan/Draft#

Amount Rs.

Deposit date

PERSONAL DETAIL Candidate Name

Father's Name CNIC/ Bay-Form Date of Birth

-

PMF Registration No. ___________________

-

CONTACT INFORMATION Postal Address Mobile:

Paramedical Training Information Institute Name Training Year

For Failed Candidates Only Previous Sesion

Registration No.

Previous Roll No.

Failed Paper(s) Detail Preference for Theory Exam Center:

Lahore

Multan

Rawalpindi

Sargodha

Bahawalpur

Faisalabad

For Regular Students Only (Should be filled by the Head of Paramedical Training Institute) This is to certify that Mr./ Miss _____________________________ s/o, d/o ____________________ has completed the training tenure for Paramedical category _________________________________ of ________________ duration, from _______________ to ____________________. His/ her overall performance and class participation is satisfactory. I recommended him/ her for the said exam.

Stamp of Head of Institute

Signature of Head of Institute

Signature of Candidate

Official Use for Accounts Branch Receipt No. ____________ Dated ________ Rs. ____________________ Bank Draft/ Pay Order No. ______________________ Accountant Signature ________________

Official Use for Examination Section The information on the front side of this form is found correct. Checked By _________________________ Counter Checked By _________________