KHYBER MEDICAL COLLEGE PESHAWAR

LEAVE APPLICATION FOR STUDENTS

Dated:__________/022
Name: _______________________________________________________________________________

Father Name: _________________________________________________________________________

Class No. ____________ Year _______________ Contact No.__________________________________

Type of leave:-
Leave/ Medical leave (attached Proof)
Reason

Days _____________________

From_________________________ to _____________________

Approved Not Approved

Signature of students/Guardian

ASSOCIATE DEAN
(Undergraduate)
KHYBER MEDICAL COLLEGE
PESHAWAR
NO.___________/SAS/KMC DATED _____________/022
Copy to
1. ChairpersonsDepartment of Anatomy, Physiology and Biochemistry.
2. Chairpersons Department of Pharmacology, Pathology and Forensic Medicine.
3. Chairpersons Department of Community Medicine, EYE and ENT.
4. Chairpersons Department of Medicine, Surgery, Paeds and Gyane/Obs.
5. Controller of Examination KMC.
6. Chief Provost KMC, Hostels.
7. All concerned Clinical Units KTH.

ASSOCIATE DEAN
(Undergraduate)
KHYBER MEDICAL COLLEGE
PESHAWAR