MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES

P.O.Box 65001, LandLine / Mobile : +255 022 2150302-6, Email : vc@muhas.ac.tz, Website :
https://muhas.ac.tz

APPLICATION FORM
Person Particulars

First Name : Omary Country of

Tanzania, United Republic of
Last Name : Omary Residence :
Other Name : Mustapha Disability : None
Sex : M Application Year : 2024/2025
Birth Date : 14-03-2000 Round : Round I
Place of Birth : MWANZA Application Type : Bachelor
Marital Status : Single Entry Category : Diploma
Nationality : Tanzanian
Contact Information

Mobile 1: 255674309551 Postal Address : 33205

Mobile 2 : 255754665032 Physcal Address : MWANZA
Email : mustaphaomary007@gmail.com
Parents / Guardians / Next of Kin Information

Next of Kin 1 Next of Kin 2

Name: MUSTAPHA OMARY KABIMA Name: NZOMWE SHABANI KAKUSU
Mobile 1 : 255713665032 Mobile 1 : 255713665032
Mobile 2 : 255754665032 Mobile 2 : 255754665032
Email : mustaphaomary007@gmail.com Email : mustaphaomary007@gmail.com
Postal : 33205 Postal : 33205
Relation : FATHER Relation : MOTHER

Application Fee Payment

Your Reference Number for payment is : 991540358016

S/No Invoice No Control No Receipt Amount Trans Time
1. 991540358016 ER240007047 10,000.00 2024-07-16 11:13:20
Total 10,000.00

Education Background

O-Level Certificate
Examination Authority : NECTA
Center Name : SUNRISE SECONDARY SCHOOL
Index Number : S2425/0134/2016
Programme Title :
Programme Title :
G.P.A/Grade : I
Country : Tanzania, United Republic of
Completed Year: 2016

SUBJECT LIST

MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES

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 MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES
P.O.Box 65001, LandLine / Mobile : +255 022 2150302-6, Email : vc@muhas.ac.tz, Website :
https://muhas.ac.tz

S/No. CODE SUBJECT GRADE

1 041 BASIC MATHEMATICS C
2 033 BIOLOGY A
3 032 CHEMISTRY B
4 031 PHYSICS C
5 022 ENGLISH LANGUAGE B
6 021 KISWAHILI B
7 013 GEOGRAPHY C
8 012 HISTORY C
9 011 CIVICS C

Diploma Certificate
Examination Authority : NACTE
Center Name : Excellent College of Health and Allied Sciences - Dar Es Salaam
Index Number : NS2425/0134/2016
Programme Title : Ordinary Diploma in Clinical Medicine
Programme Title : Ordinary Diploma in Clinical Medicine
G.P.A/Grade : 4.2
AVN :
Country : Tanzania, United Republic of
Completed Year: 2023

SUBJECT LIST

S/No. CODE SUBJECT GRADE

1 CMT06209 Apprenticeship in Paediatrics and Child Health A
2 CMT06209 Apprenticeship In Paediatrics And Child Health A
3 CMT06208 Apprenticeship in Internal Medicine A
4 CMT06208 Apprenticeship In Internal Medicine A
5 CMT06207 Apprenticeship in Surgery A
6 CMT06207 Apprenticeship In Surgery A
7 CMT06206 Apprenticeship in Obstetrics and Gynaecology B+
8 CMT06206 Basics Of Forensic Medicine B+
9 CMT06105 Surgical Specialities B+
10 CMT06105 Surgical specialities B+
11 CMT06104 Basics of Forensic Medicine A
12 CMT06104 Health policy and planning A
13 CMT06103 Operational Research B
14 CMT06103 Operational research B
15 CMT06102 Leadership and Management B
16 CMT06102 Leadership and management in health B
17 CMT06101 Entrepreneurship and Life Skills B
18 CMT06101 Basics of family medicine B

Programme Choices

First Choice : Doctor of Medicine

Second Choice : Doctor of Medicine
Third Choice : Doctor of Medicine

MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES

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 MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES
P.O.Box 65001, LandLine / Mobile : +255 022 2150302-6, Email : vc@muhas.ac.tz, Website :
https://muhas.ac.tz

Fourth Choice : Doctor of Medicine

Declaration

I, Omary Mustapha Omary hereby declare that the information given in this form is true to the best of my knowledge

MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES

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