HR DEPARTMENT

APPLICATION FORM FOR MCPS TRAINING

REHMAN MEDICAL INSTITUTE
5/B-2 Phase - 5 Hayatabad Peshawar Pakistan. Tel: +92-91-5838000 | UAN: 111-REH-MAN | Fax: +92-91-5838333 jobs@rmi.edu.pk | www.rmi.edu.pk

For Office Use Only Yes Short Listed for: Called on: Interviewed: Selected: No

PHOTOGRAPH

To be filled in by the applicant. Please fill in BLOCK letters.

Date: Full Name (Dr.) Single Father s / Husband s Name Date of Birth National ID Card No. Place of Birth Domicile Male Nationality
, ,

Subject Applied For (Please Tick Only One of the Following Discipline)
Anaesthesia Obs & Gynae Paeds Pathology Radiology

*(Females only for Obs & Gynae) Marital Status Married Gender Female Other

Present Address: District: Permanent Address: District: Telephone Number (Residence) E-Mail Address: Mobile Number: Province: Country: Province: Country:

EDUCATION Qualification
Medical Graduation

Name of the Institution

Obtain/Total Marks / / / / From

%age

Attempts

Year of Passing

1st Prof 2nd Prof 3rd Prof Final Prof House Job

To

Name & Address of Medical College / University

PMDC Reg. No.

Attach a photocopy of CNIC and two recent photographs. Photocopies of all necessary documents, including MBBS academic certificate showing detailed marks/attempts of all years. House job certificates. All information fields are mandatory to be filled by the applicant. Incomplete form will not be entertained.

Signature