Application Form IHM 20110625
Application Form IHM 20110625
Application Form IHM 20110625
Photograph
Fathers Name
Department
Birth Location
Male
Female
Home Address
(as mentioned in NIC)
E-mail:
Country
Duration
Result (% A-D)
APPLICANTS DECLARATION
I certify that the information in this application is accurate to the best of my knowledge. Furthermore I agree to inform to the admission cell, DUHS immediately of changes and amendments. I have taken note of the information provided in and regarding this application as well as the notice about the storage of personal data. I accept responsibility for the completeness of my application. I agree that this application and accompanying documents shall remain with the admission cell, Dow University of Health Sciences.
Place
Date
Signature
3) Permanent Address
4) Final year Graduate examination a. Date of Passing b. Division / Grade Institute Registration No. Total Marks Obtained / Maximum Marks
c. No. of attempts in which passed d. Whether received any warning or punishment during the time when he/she was student of the college, if so give details
It is further certified that during his/her period of stay in this college his/her work, conduct & character was
Place Date
8. Permanent Address
9. Email address 10. Office Phone 11. Res. Phone 12. Any Other Contact Number 13. Annual Income 15. Nationality 16. NADRA NIC No.
(for Pakistani Candidate only)
Mobile Phone
14. Religion
NOTE: If father is working abroad. These particulars must be endorsed by Pakistan embassy / consulate of the respective country.
Signature of father
Health Certificate
Note: (Section A, B, & C will be filled by the candidate)
Section A
Name Age Height: Present Address: Days Months S/o, D/o Years Weight:
Section B
1. Do you smoke? ................................................... 2. Do you take any medicine regularly? ....................... If yes, Specify 3. Any history of allergy .......................................... 4. Do you suffer from any of the following diseases? ........ i. Epilepsy ..................................................... ii. High Blood Pressure ...................................... iii. Psychiatric illness ....................................... iv. Rheumatic Heart Disease ............................... v. Hepatitis B/C .............................................. vi. Physical Disability ........................................ If yes, Specify Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No Yes Yes No No
Signature
Note:
DO NOT attach this sheet or its photocopy with the application form.
ADMIT CARD
FOR ENTRY TEST
FOR ADMISSIONS in BBA / MBA / EMBA
Candidates Copy
Roll No.
Please Paste (1 x 1) Photograph
Mobile No:
Date:
Reporting Time:
E.mail:
For Official Use Name: Signature Seal
Venue:
Note: See Instructions Overleaf
at
E.mail:
For Official Use Date:
Rep. Time:
Signature of Candidate
Venue: