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Mohi-ud-Din Islamic Medical College Sector D-4, Mirpur (AJ&K) Application Form

This document is an application form for admission to Mohi-ud-Din Islamic Medical College for the 2018-23 session. It requests information such as the applicant's name, ID number, date of birth, educational qualifications, selected admission basis, and contact information. The form also includes undertakings by the applicant and father to provide correct information, as well as a list of required documents to attach including matriculation certificate, F.Sc transcripts, domicile certificate, CNIC, and photograph.

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Usama Tariq
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72 views2 pages

Mohi-ud-Din Islamic Medical College Sector D-4, Mirpur (AJ&K) Application Form

This document is an application form for admission to Mohi-ud-Din Islamic Medical College for the 2018-23 session. It requests information such as the applicant's name, ID number, date of birth, educational qualifications, selected admission basis, and contact information. The form also includes undertakings by the applicant and father to provide correct information, as well as a list of required documents to attach including matriculation certificate, F.Sc transcripts, domicile certificate, CNIC, and photograph.

Uploaded by

Usama Tariq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Mohi-ud-Din Islamic Medical College

Sector D-4, Mirpur (AJ&K)


Application Form (MBBS)
Session 2018-23

Name of Candidate: _____________________________________________________


NUMS Student ID ____________________ Merit List No. _____________________ Attach
recent
Fee Deposited Rs. ____________________ Date ______________________ passport size
photo
Name of Bank and Branch ________________________________________________
Bank Challan No _______________________________________________________

Date of Birth _____________ Age: ____________ Marital Status________________

Candidate Email ________________________________________________________

Father’s Name ________________________________________________________

Father’s Profession _____________________________________________________

Designation ____________________________________________________________

Office/Business Address _____________________________________________________________________

__________________________________________________________________________________________

Phone Office ________________________ Fax _______________________ Mobile ___________________

Present Mailing Address of Parents ____________________________________________________________

_________________________________________________________________________________________

Phone Res ________________________ Fax _______________________ Mobile ____________________

Permanent Address __________________________________________________________________________

___________________________________________________________________________________________

Nationality of Candidate _______________________ NIC/Form B # __________________________________

Passport # (Foreign /Expatriate Students)_________________________________________________________

Name of Guardian (If other than father)___________________________________________________________

Occupation of Guardian____________________ Phone# ___________________Fax#_____________________


Educational Qualification
Please attach attested photocopies of the supporting documents

Degree/Certificate Institution Attended Board University Grade/Marks Year Passed


/Diploma

Selected on Seat
Open merit
Foreign/Dual National/ Overseas

Co- Curricular Activities

___________________________________________________________________________________________

___________________________________________________________________________________________
Hostel

I wish to reside in the College Hostel Yes No


If yes please fill in Hostel Application Form
Undertaking
I solemnly declare that the information provided in the application form and documents attached with application
form are correct and no information asked has been concealed. The provision of incorrect information/document will
disqualify me for admission or continuation of my studies at Mohi-ud-Din Islamic Medical College.
Candidate’s Name __________________________________ Signature_____________________________
Father’s Name: _______________________________________Signature ____________________________

Date: ____________________________
Requirements
Please attach attested copies of the following documents:
1 -Matriculation Certificate
2 -F. Sc. (Physics, Chemistry, Biology) [Minimum of 60% marks] (For foreign, dual nationality holders or
overseas Pakistani candidates: Chemistry, Biology and either Physics or Mathematics with 60% in
aggregate certified by IBCC is mandatory
3- Domicile Certificate 4– CNIC / Form B 5- Photograph (8) passport size
6- Copy of mark sheet of entry test (Provincial/Govt)

Mailing Address

Registrar, Principal,
Mohi-ud-Din Islamic University, Mohi-Ud-Din Islamic Medical College,
Camp Office Union Council Road, Industrial Area, Mirpur,
Sihala, Islamabad, AJ&K. Ph #: +92-5827-468159
PAKISTAN. Ph #: +92-51-4485831-2,

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