REGISTRATION FORM Reg. No.

To be Filled by NTS

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WAPDA (DIRECTOR GENERAL) Paste your recent

MEDICAL SERVICES passport size color

photograph with gum

Screening test for vacant situations

for Employees Already Working on Temporary Basis

Eligibility Criteria:
A. Is your Age according to the prescribed age limit for the desired Post as on 20-10-2016? Yes No

B. Do you have relevant / prescribed Qualification & Experience as mentioned? Yes No

C. Is your Domicile according to the desired post as mentioned in Advertisement? Yes No

If your reply is Yes to A, B & C above, only then please proceed further. Otherwise you are not eligible to apply.

01. Bank Online Deposit of Rs: 450/- from Designated Bank Branches
Bank Code Deposit Date

*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy)

02. Desired Post & Station: Fill the Box for Desired Post & Station. (Mandatory)
To apply for more than one posts, please use separate form with separate fee. This form will be considered valid only for the first selected post in the sequence.

Stations with Vacancies

Posts
Hospitals Dispensaries

01. Lahore 02. Faisalabad 01. SPS Faisalabad 02. Chashma

01. Medical Officer (BPS-17) 03. Gujranwala 04. Multan 03. Jhang 04. Sialkot

05. Peshawar 06. Tarbela 05. Warsak

01. Faisalabad 02. Gujranwala 01. Jhang 02. Gujrat

03. Mangla 04. Multan 03. R.Y Khan 04. Dargai

Lady Medical Officer
02. (BPS-17)
05. Rawalpindi 06. Peshawar 05. Barotha

07. Tarbela

01. Faisalabad 02. Peshawar 01. Sahiwal 02. Warsak

03. Dental Surgeon (BPS-17)
03. Tarbela 03. RBC Tarbela 04. Shalamar Lahore

01. Rawalpindi 02. Multan 01. Muzaffargarh 02. R.Y Khan

03. Gujranwala 04. Faisalabad 03. Jhang 04. SPS Faisalabad

04. Staff Nurse (BPS-16)
05. Lahore 06. Mangla 05. RBC Tarbela

07. Tarbela
 03. Desired Test City: Fill Only One Box (Mandatory)
(Subject to a minimum of 200 candidates, other wise the candidates will be assigned next nearest test city)

01. Islamabad / Rwp 02. Lahore 03. Bahawalpur 04. Karachi

05. Peshawar 06. Quetta

04. Province of Domicile Fill Only One Box for Desired Province Domicile as mentioned in Advertisement (Mandatory)

01. Punjab (Including Islamabad) 02. Khyber Pakhtunkhwa 03. Balochistan 04. Sindh (Urban)

05. Sindh (Rural) 06. AJK 07. Gilgit Baltistan 08. FATA

Personal Information: Use CAPITAL letters and leave spaces between words.
05. Name in Full:

06. Fathers Name:

07. Candidate CNIC #:

Write your own CNIC No. Or B Form No.

09. Date of Birth: D D M M Y Y

08. Gender: Male Female Write your Correct Date of Birth
otherwise you will be rejected 1 9

10. Postal Address:

All correspondence will be made on this address though courier service or ordinary postal service.

City: District:

11. Phone No: (OFF) (RES.) (Mobile)

City Code - Phone No Mandatory

12. Are you a Govt. Servant / Autonomous bodies If Yes then total years of
Yes No continuous experience:
Employee? In case of Yes, please attach NOC
13. Are you a Disabled Person? If yes, state nature
If yes, please attach Disability Certificate Yes No of your disability:

If Non Muslim,
14. Religion: Muslim Non Muslim Please Specify:

15. Are you registered with PMDC? Yes No If yes then Please Specify
PMDC Registration No:

16. Are you already a serving employee of WAPDA Medical Services? Yes No

If Yes,
Please Specify Station:
17. Academic Information: (Please attach attested copies of your academic certificates.)
Note: 1. NTS will not issue Roll No Slips to those who have not filled in their academic record properly.
2. Candidate should convert their grades into marks. (O Level / A Level or any other degree having grade).
3. Write exact degree name & major subject mention in certificate / transcript.
4. Result awaiting candidates are not eligible.

Certificate /
Degree Title Specialization / Major Subject Year Passing Obtained Marks / CGPA Total Marks / CGPA Board / University / Country
Degree Name

Matric
(10 Years)

Intermediate
(12 Years)

Bachelor
(14 Years)

Bachelor (Hons)
/ Master
(16 Years)

MBBS / BDS MBBS

Equivalent
Qualification BDS

MBBS / BDS
Equivalent
Qualification
(In case of abroad)

Higher
Qualification
(If Any)

Course /
Diploma /
Certificate

Degree First Professional Second Professional Third Professional Final Professional

Name Obtained Marks Total Marks No. of Attempts Obtained Marks Total Marks No. of Attempts Obtained Marks Total Marks No. of Attempts Obtained Marks Total Marks No. of Attempts

MBBS
/ BDS

18. Employment Record: (Please attach attested copies of your experience certificates.)
(Only Post Qualification Job Experience will be considered)
Job Duration
Organization / Employer Name Write only Month & Year
Sr # (Please write the most recent first) Job Title
From To

01

02

03

Days Months Years

19 Total Post Qualification Job Experience as on closing date of applications:

Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do hereby solemnly
declare and affirm that I have read and understood the instructions and conditions for appearing in
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the NTS Test, and I have filled-up the application form as per instructions given below. In case of any Affix your recent
information contained herein is found at any stage to be missing, untrue, false or forged, my passport size color
candidature can be canceled at any stage (even after employment, if so revealed later), and I shall photograph
be liable to legal action. with Stapler

Date: _________ Thumb Impression ____________ Candidates Signature ________________

General Instructions / Information:

Please fill the Application Form properly with complete and correct information / answers.

Please DO NOT leave any field blank, otherwise your application may not be considered.

Incorrect, false or forged information may result in cancellation of your candidature at any stage, even after employment,
and also proceeding of a legal action.

Attach your Two recent Passport Size Photographs, Attested copies of CNIC, Domicile Certificate, Academic Certificates,
Experience Certificates and Original Bank Deposit Slip (NTS Copy)

By Hand submission of Application Form is not allowed.

Mobile Phones or any Electronic Gadgets are not allowed in Test Center premises.

Use separate envelop and separate application form for each post you are applying for.
Last date for submission of application form is Thursday
20th October, 2016.
Applications received on or after Friday
21st October, 2016 will be rejected.

Application should reach NTS office latest by last date of submission of Application Form.

NTS will not be responsible for late receiving of application through courier / Pakistan Post etc.

Please Send Application Forms to:

HELP LINE:
WAPDA (Director General)
UAN : +92-51-844-444-1
Website : www.nts.org.pk Medical Services (Project)
National Testing Service
1-E, Street No. 46, Sector I-8/2, Islamabad.
 Building Standards in Educational and Professional Testing Building Standards in Educational and Professional Testing

WAPDA (Director General) Medical Services WAPDA (Director General) Medical Services
Branch Code: Date: Branch Code: Date:

Branch Name: Branch Name:

ONLINE DEPOSIT SLIP
(* Please deposit fee in only one bank & tick the relevant bank)

Allied Bank Limited Muslim Commercial Bank Allied Bank Limited Muslim Commercial Bank
(Formely: Allied Bank of Pakistan Limited) (Formely: Allied Bank of Pakistan Limited)

Remote Remote Remote Remote

Branch: I-8 Markaz Branch Islamabad (0140947) Branch: I-8 Markaz Branch, Islamabad (1501) Branch: I-8 Markaz Branch Islamabad (0140947) Branch: I-8 Markaz Branch, Islamabad (1501)
A/C A/C A/C A/C A/C A/C A/C A/C
Title: NTS-Pakistan-Collection No. 0010008325640018 Title: NTS-Pakistan 647943831003775
No. Title: NTS-Pakistan-Collection No. 0010008325640018 Title: NTS-PakistanNo. 647943831003775
Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost

LTD LTD
THE POWER TO LEAD THE POWER TO LEAD
Remote Remote
Branch: Cantt Br Kashmir Road Rawalpindi (0041) Remote H9 Shalimar Recording Co ISB (1742)
Branch: Cantt Br Kashmir Road Rawalpindi (0041) Remote H9 Shalimar Recording Co ISB (1742)
Branch: Branch:
A/C A/C A/C A/C A/C A/C A/C A/C
Title: NTS- Pakistan No. 217767828 Title: NTS-Pakistan No. 17427900464503 Title: NTS- Pakistan No. 217767828 Title: NTS-Pakistan No. 17427900464503
Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost
*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original *Note:
Deposit Slip (NTS Copy) along Application Form to NTS Office 1. Please Stamp both copies of deposit Slip.
a 2. The Bank Must Return NTS Copy to the Candidate.
Application Form will not be entertained without Original Deposit Slip (NTS Copy) 3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.

Applicants Applicants
Name: Name:
Father Father
Name: Name:
CNIC No/ CNIC No/
B Form No: B Form No:

Post Name: Post Name:

Amount Amount in Four Hundred & Fifty Rupees Only Amount 450/- Amount in Four Hundred & Fifty Rupees Only
Rs:
450/- word: Rs. Rs: word: Rs.
Non Refundable/ Non Transferable Non Refundable/ Non Transferable

Applicant Signature Cashier Officer Applicant Signature Cashier Officer