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  • FCPS MS MD Application Form 1

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    Doctor Fit
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    The document is an application form for a post at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad. It requests information such as the applicant's name, age, father's name, nationality, contact details, academic and professional qualifications including degrees earned and years of study, research publications, and an undertaking by the applicant confirming the accuracy of the information provided.

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    FCPS-MS-MD-Application-form-1

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    The document is an application form for a post at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad. It requests information such as the applicant's name, age, father's name, nationality, contact details, academic and professional qualifications including degrees earned and years of study, research publications, and an undertaking by the applicant confirming the accuracy of the information provided.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    5 views1 page

    FCPS MS MD Application Form 1

    Uploaded by

    Doctor Fit
    The document is an application form for a post at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad. It requests information such as the applicant's name, age, father's name, nationality, contact details, academic and professional qualifications including degrees earned and years of study, research publications, and an undertaking by the applicant confirming the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
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    of 1

    FEDERAL MEDICAL TEACHING INSTITUTE

    PAKISTAN INSTITUTE OF MEDICAL SCIENCES


    ISLAMABAD
    Post Applied: - _________________________________ Speciality:-_________________________________________
    Name: __________________________________________ Age:- Years(__)Months(__)Day(__)Domicile______
    Father’s Name: ____________________________________________________Nationality:_____________________
    Postal Address: ______________________________________________________________________________________
    Phone Number: _____________________________________ Cell Number: _________________________________
    Email: ___________________________________________CNIC:_______________________________________________
    PMC registration No: ____________________________ Valid up _________________________________________
    FCPS-I/MD/MS/MDS passing year’s ______________________________
    House Job from: Public Private PIMS
    MBBS Passing sector: Public Private Foreign
    Academic / Professional Record:
    Examination Year of Marks Total Name of No of Name of the
    Passed Passing Obtained Marks College attempts Board /
    University
    Matric
    FSC
    MBBS/BDS (1st Year)
    MBBS/BDS (2nd Year)
    MBBS/BDS (3rd Year)
    MBBS/BDS (4th Year)
    MBBS (5th Year)

    Total Marks of MBBS/BDS Percentage of MBBS/BDS


    5 years (combine)

    Number of Research Name of journal


    publication

    Distinction(s), if any_________________________________________________________________________________

    Undertaking by the Applicant


     I hereby undertake that the information given above by me is correct and I have not
    concealed.

    Name & Signature of the Candidate

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