Szabmu Form New

Reg. No.
REGISTRATION FORM
NTS
To be Filled by NTS
Shaheed Zulfiqar Ali Bhutto

Medical University
PIMS, G-8/3 Islamabad
Picture 1
Paste your
recent
passport size
color photograph
with gum
Entry Test
Admission in 32 Disciplines of Residency Training Programs
and 12 Disciplines of Basic Medical Sciences
1. Bank Online Deposit of Rs: 2000/- from Designated Bank Branches.

Deposit Date
Bank Code
*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy)
2. Desired Program Fill Only One Box for Desired Program. (Mandatory)
To apply for more than one posts, please use separate form. This form will be considered valid only for the first selected post in the sequence.
GAT Medicine and Allied Disciplines

01. MD (Cardiology)
02. MD (Critical Care Medicine)
03. MD (Dermatology)
04. MD (Endocrinology)
05. MD (Gastroenterology)
06. MD (Histopathology)
07. MD (Internal Medicine)
08. MD (Neonatology)
09. MD (Nephrology)
10. MD (Neurology)
11. MD (Paediatric Medicine)
12. MD (Pediatric Medicine)
13. MD (Psychiatry)
14. MD (Pulmonology)
15. MD (Radiology)
16. MD (Rheumatology)
GAT Surgery and Allied Disciplines

01. MS (Accident & Emergency)
02. MS (Anaethesia)
03. MS (Burn Surgery)
04. MS (Cardiac Surgery)
05. MS (E.N.T)
06. MS (General Surgery)
07. MS (Neuro Surgery)
08. MS (Obstetrics and Gynecology)
09. MS (Ophthalmology)
10. MS (Orthoedics)
11. MS (Paediatric Surgery)
12. MS (Plastic Surgery)
13. MS (Urology)
GAT Dentistry & Allied Disciplines

01. MDS (Maxillofacial Surgery)
02. MDS (Operative Dentistry)
03. MDS (Pediatric Dentistry)
Basic Medical Sciences Disciplines (Ph.D Program)

01. Ph.D (Biochemistry)
02. Ph.D (Chemical Pathology)
03. Ph.D (Haematology)
04. Ph.D (Molecular Biology)
Basic Medical Sciences Disciplines (M.Phil Program)

01. M.Phil (Biochemistry)
02. M.Phil (Chemical Pathology)
03. M.Phil (Haematology)
04. M.Phil (Histopathology)
05. M.Phil (Microbiology)
06. M.Phil (Physiology)
07. M.Phil (Pharmacology)
08. M.Phil (Medical Lab Technology)
3. Desired Test City: Fill Only One Box
(Mandatory)
(Subject to a minimum of 100 candidates, other wise the candidates will be assigned next nearest test city)
01.
Islamabad
02.
Lahore
03.
Karachi
04.
Peshawar
05.
Quetta
06.
Multan
07.
Faisalabad
08.
Gujranwala
09.
Muzaffarabad
10.
Hyderabad
11.
Gilgit
Personal Information: Use CAPITAL letters and leave spaces between words.
04. Name in Full:
05. Fathers Name:
06. Candidate CNIC #:
Write your own CNIC No. Or B Form No.
07. Gender:
Male
08. Date of Birth:
Female
Write your Correct Date of Birth

otherwise you will be rejected
1 9
09. Email:
10. Postal Address:
All correspondence will be made on this address though courier service or ordinary postal service.
Postal City
District:
City:
11. Phone No: (OFF)
(RES.)
(Mobile)
City Code - Phone No
Mandatory
12. PMDC Registration No:
13. Valid Upto:
14. Nationality:
15. Domicile:
For Pakistani nationals only
16. Academic Information: (Mandatory)

Certificate /
Degree Level
Year of
Passing
Major Subject
Total
Marks
Obtained
Marks
Percentage
Institute/Board
Matric /
O Level
(10 Years)
F.Sc /
A Level
(12 Years)
Bachelor /
Master
(If applicable)
(16 Years)
M.Phil
For Medical / Dental Graduates (Mandatory)

Degree
Name
MBBS
BDS
First Professional
Part I
Percentage
Marks
No. of
Attempts
Part II
Percentage
Marks
No. of
Attempts
Second
Professional
Percentage
Marks
No. of
Attempts
Third
Professional
Percentage
Marks
No. of
Attempts
Final
Professional
Percentage
Marks
No. of
Attempts
Year of
Passing
Name of Medical College /

University
17. House Job: (Mandatory)
For admission in Residency Training Program
I) Hospital / Institute Name:

D
II) Date From:
III) To:
IV) Duration:
18. Employment Record:

Job Duration
Sr #
Organization / Employer Name
Job Title
Write only Month & Year
From
To
01
02
03
Years
Months
19. Total Job Experience:
Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do hereby
solemnly affirm that I have read and understood the instructions and conditions for
appearing in the NTS Test and that I have filled-up the application form as per instructions
given below, and in the event of any information contained herein is found at any stage to
be missing, untrue, false or forged, I shall be liable to legal action either by NTS or the
Partner Organization and also cancellation of my candidature and suitability for
employment at any stage even after employment.
Date: ________________
Picture 2
Affix your
recent
passport size
color
photograph
with Stapler
Signature of the Candidate__________________
INSTRUCTIONS:
Please fill the Application Form properly with complete and correct information/answers.
Please DO NOT leave any answer blank, otherwise your application shall be rejected by the
computer.
All information provided in this application form will be verified, and original documents will be
demanded and verified in case of offer of Admission.
Incorrect, false or forged information may result in cancellation of your candidature at any stage,
even after admission, and also proceeding of a legal action either by NTS or the Partner
Organization.
Attach your Two recent Passport Size Photographs, CNIC Copy and Original Bank Deposit Slip
(NTS Copy)
By Hand submission of Application Form is not allowed.
Mobile Phones are not allowed in Test Center premises.
rd
Last date for application submission is Sunday, 3 May 2015.
Application should reach NTS office latest by last date of submission of Application Form.
NTS will not be responsible for late receiving of application through courier / Pakistan Post etc.
th
Applications received on or after Monday, 4 May 2015 will not be entertained by NTS.
Help line:
UAN. +92-51-844-444-1
Website:
www.nts.org.pk
Please Send Application Forms to:

SZABMU Entry Test (Project)
National Testing Service
1-E, Street No. 46, I-8/2,
Islamabad.
National Testing Service-Pakistan
National Testing Service-Pakistan
Building Standards in Educational and Professional Testing
Building Standards in Educational and Professional Testing
Date:
Branch Code:
Date:
Branch Code:
Branch Name:
Branch Name:
ONLINE DEPOSIT SLIP

(* Please deposit fee in only one bank & tick the relevant bank)
Muslim Commercial Bank
Allied Bank Limited
Muslim Commercial Bank
Allied Bank Limited
(Formely: Allied Bank of Pakistan Limited)
(Formely: Allied Bank of Pakistan Limited)
Remote
I-8 Markaz Branch Islamabad (0140947)
Branch:
A/C
A/C
Title: NTS-Pakistan-Collection No. 0010008325640018
Remote
Branch:
A/C
Title:
I-8 Markaz Branch, Islamabad (1501)

A/C
No.
Remote
I-8 Markaz Branch Islamabad (0140947)
Branch:
A/C
A/C
Title: NTS-Pakistan-Collection No. 0010008325640018
Remote
Branch:
A/C
Title:
I-8 Markaz Branch, Islamabad (1501)
Note: Bank Service Charges Free of Cost
A/C
0041749181000999
No.
Remote H9 Shalimar Recording Co ISB (1742)

Branch:
A/C
A/C
No. 1742-79002786-03
Title: NTS-Collection
Remote
Branch:
A/C
Title:
Remote H9 Shalimar Recording Co ISB (1742)

Branch:
A/C
A/C
No. 1742-79002786-03
Title: NTS-Collection
0041749181000999
Remote
Branch:
A/C
Title:
NTS-Collection
NTS-Collection
LTD
LTD
THE POWER TO LEAD
Cantt Br Kashmir Road Rawalpindi (0041)

NTS- Pakistan
A/C
No.
217767828
THE POWER TO LEAD
*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original
Deposit Slip (NTS Copy) along Application Form to NTS Office
a
Application Form will not be entertained without Original Deposit Slip (NTS Copy)
Cantt Br Kashmir Road Rawalpindi (0041)

NTS- Pakistan
Father
Name:
Father
Name:
CNIC No/
B Form No:
CNIC No/
B Form No:
Applicant Signature
Amount in
word: Rs.
Two Thousand Rupees Only
Amount
Rs:
Non Refundable/ Non Transferable
Cashier
(SZABMU 03-05-2015)
Officer
1. Please Stamp both copies of deposit Slip.

2. The Bank Must Return NTS Copy to the Candidate.
3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.
Applicants
Name:
2000/-
217767828
*Note:
Applicants
Name:
Amount
Rs:
A/C
No.
2000/-
Applicant Signature
Amount in
word: Rs.
Two Thousand Rupees Only

Non Refundable/ Non Transferable
Cashier
(SZABMU 03-05-2015)
Officer

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Reg. No.

Shaheed Zulfiqar Ali Bhutto

1. Bank Online Deposit of Rs: 2000/- from Designated Bank Branches.

GAT Medicine and Allied Disciplines

02. MD (Critical Care Medicine)

07. MD (Internal Medicine)

11. MD (Paediatric Medicine)

12. MD (Pediatric Medicine)

GAT Surgery and Allied Disciplines

03. MS (Burn Surgery)

04. MS (Cardiac Surgery)

06. MS (General Surgery)

07. MS (Neuro Surgery)

08. MS (Obstetrics and Gynecology)

11. MS (Paediatric Surgery)

12. MS (Plastic Surgery)

GAT Dentistry & Allied Disciplines

02. MDS (Operative Dentistry)

03. MDS (Pediatric Dentistry)

Basic Medical Sciences Disciplines (Ph.D Program)

02. Ph.D (Chemical Pathology)

03. Ph.D (Haematology)

04. Ph.D (Molecular Biology)

Basic Medical Sciences Disciplines (M.Phil Program)

02. M.Phil (Chemical Pathology)

03. M.Phil (Haematology)

04. M.Phil (Histopathology)

05. M.Phil (Microbiology)

06. M.Phil (Physiology)

07. M.Phil (Pharmacology)

08. M.Phil (Medical Lab Technology)

3. Desired Test City: Fill Only One Box

08. Date of Birth:

Write your Correct Date of Birth

City Code - Phone No

12. PMDC Registration No:

13. Valid Upto:

16. Academic Information: (Mandatory)

For Medical / Dental Graduates (Mandatory)

Name of Medical College /

17. House Job: (Mandatory)

For admission in Residency Training Program

I) Hospital / Institute Name:

II) Date From:

18. Employment Record:

Organization / Employer Name

Write only Month & Year

19. Total Job Experience:

Undertaking By The Applicant:

Signature of the Candidate__________________

By Hand submission of Application Form is not allowed.

Mobile Phones are not allowed in Test Center premises.

Please Send Application Forms to:

National Testing Service-Pakistan

National Testing Service-Pakistan

Building Standards in Educational and Professional Testing

Building Standards in Educational and Professional Testing

ONLINE DEPOSIT SLIP

Muslim Commercial Bank