Form No.

POSTGRADUATE MEDICAL INSTITUTE/

AMEER-UD-DIN MEDICAL COLLEGE,

Photograph

6-BIRD WOOD ROAD, LAHORE

POST APPLIED FOR

__________________________________________________

1.

Name

2.

D/o, W/o, S/o _____________________________________________________

3.

Date of Birth/Age___________________________________________________

4.

Domicile__________________________________________________________

5.

Address:
a. Permanent_______________________________________________________
b. Postal address for immediate
Contact (in Lahore only)._____________________________________________

6.

Contact Telephone No._______________ Mobile No._______________________

_____________________________________________________

7.
Marital Status
_____________________________________________________
8.
PM & DC valid Registration No. ________________Date of
Expiry______________

9.

Qualification.

Sr. No.

Name of Degree

1.

Matric

2.

F.Sc.

3.
(i)

MBBS

(ii)

2nd
Professional

(iii)

3rd Professional

(iv)

4th Professional

(V)

Final
Professional

Higher
Qualification
Additional
Qualification

1st Professional

Total
marks

Marks
obtained

Percentag
e

Institution

Year

10.

Hafiz-e-Quran ________________________________________________

11.

Experience. ___________________________________________________

Experience as

Year

Month

Days

12. Position at University Level / Medical College:a. 1st in Final Prof. MBBS
b. 2nd in Final Prof. MBBS
DISTINCTION IN SUBJECT (MBBS)
a. Distinction with 80% and above
Marks in a subject Professional
exam.
i.

Medal/Distinction in Fellowship
or Distinction in FCPS.
ii. Distinction in M.Phil

13.

Attested photocopies of documents should be attached as per

following guides:a.

Matriculation Certificate.

b.
c.

F. Sc, MBBS along with all Professional

Certificates.
Postgraduate Degree/certificates.

d.

Experience Certificate.

e.

Domicile Certificate.

f.

National Identity Card. (CNIC)

g.

Research papers.

h.

If Govt. servant N.O.C. of the Department.

14.

Deposit Office: Diary Section of AMC/PGMI (Administration Block)

Last date of receipt of application is 12-04.2016.
15.
Any other information can be obtained from the Admin Officer,
PGMI/AMC.
College/PGMI, Lahore.
16. Incomplete application will not be entertained.
Date of submission_____________
Candidate

Signature of the