House Officer Application Perfoma

SHEIH ZAYED HOSPITAL RAHIM YAR KHAN
APPLICATION FORM FOR HOUSE JOB

Merit Number
1 Diary Number (Office Use Only)
(Office Use Only)
Applicant Name (DR)
2
(CAPITAL LETTER) Paste Passport Size
3 S/O D/O W/O Photograph
Do not staple
4 Father Profession
Date of Birth
5
(DD-MM-YY) / Place of Birth
6 CNIC Number
7 Date of Gradution (MBBS)Month/Year Nationality
Institute from where Graduated (Fill One
8 Religion
option whichever is applicable)
a Host Institute
b Other Public Sector Institute Punjab
Other Public Sector Institute other
c
province
d Private Sector Institute
e Foreign Graduate
9 District of Domicile
10 Marital Status Cast
PMC Provisional Registration
Number or Receipt of Application of Blood Group &
11
Registration to PMC R.H.Type
(PMC necessasry for FMGs)
12 Email Address
13 Telephone (Residence) (Mobile)
14 Passport Number (Foreigners)
15 Mailing Adress
Permanent Address
16
(If different from above)
17 Bank Account Bank/Branch
18 Marks Obtained MBBS Final Year
19 Total Marks of Final Year MBBS
20 %age of Marks Obtained
Rotation Pereference
(Please mention your preferred rotations in order of priority, as per notified list of units of this hospital)
Rank Preferred Rotation
1
2
3
4
Important Instructions
The form is to be submitted to the Office of the Medical Superintendent, Sheikh Zayed Hospital Rahim Yar Khan as
1
per notified schedule.
Lists of Selected House Officer based merit shall be displayed on the notice board of Medical Superintendent,
2
concerned Units as well as at the official web page https://www.facebook.com/SZHRYKhan
Documents to attached (attested photocopies)
a. Matric Certificate
b. FSC Certificate
c. MBBS Degree / Provisional Certificate
3 d. Result Cards of all Professional exams, CNIC / Passport
e. Domicile
f. PMC Registraiton (or receipt of application of registraiton to PMC), PMC registration is necessasry for
FMGs, without PMC registration Certificate no application accpted from FMGs.
g. Three Passport size Phortogrpah (one to be paste on the front page and two to be stappled)
4 No application shall be entertained without the above documents.
5 No Dues certificate (NOC) from Warden Boys / Girsl Hostel from concerned Univeristy / College.
Compulsory Rotations:
a. Major Medicine
6 b. Major Surgery
c. Minor Speciality (Allied Medicine)
d. Minor Speciality (Allied Surgery)
7 Evert Applicant must option for the four compulsory rotations of three months each.
Applicants will be divided into 4 batches. Each bach will be rotated according to their merit, Major Medicine , any
8 allied Medicine & Major Surgery, any allied Surgery (as per schedule for rotation)
In case of termination of Job, experience certificate will not be issued, House Job certificate will only be issued after
9 the testimonial of the Head of Department / Unit.
Declaration
I) I do hereby solemnly declared that the informaiton given by me in this applicatin form is true and correct to the
best of my knowledge and believe. I fully understand that the facts given above will serve as the basis for
determinatin of my eligibility by the concerned Authorities. My candidature so determned by the Board / Authorities
will stand provisional until, it is verified with the original certificates at the time of interview. I will not claim benefit
of any information which is not mentioend in the application form and is proceed later on.
II) i declared that i have not been already employed anywhere for House Job and I am submitting my applicatoin
through proper channel and I will ensure that I shall resigned from my existing post (if any) when selected.
III) I undertake to serve for the terms of one Year in case of Selection as an Internee House Surgeon / Physician.
IV) I solemenly declared that I shall be legally bound to surrender my security of Rs. 1000/- in case i leave House Job
before due date.
V) I undertake to produce the registration of PMC.
VI) I have also read the rules and regulations and I am submitting the Affidavit on Judicial Paper worth Rs. 50/- duly
signed and attested by the Oath Commissioner.
I also understand that after the submission of application, if my application stands incomplete, wrongly filled,
unsignd or misstated in the aove replies, disciplinary action shall be taken against me under the rules.
Signature of the Applicant
Official Use Only

Comments / Status
SAMPLE OF AFFIDAVIT TO BE SUBMITTED ON JUDICIAL PAPER OF RS. 100/- ATTESTED BY THE
OATH COMMISSIONER.
AFFIDAVIT
I Dr. _______________________________ S/O, D/O, W/O _______________________, House Officer,

(Sheikh Zayed Hospital Rahim Yar Khan do hereby solemnly declared and affirm as under:
1. I will not take part in any association / Union.
2. I will not take part in any sbuversive activities i.e. strikes, demonstrations, slogans, etc.
3. I will be bound to abide by the rules, regulations and orders issued by the Hospital Authorities. i have read the
rules and regulations carefully.
4. That if, I am found indulged in any such activities and violations of rules and regulations, my House JOb will be
liable to be terminated without assigning any notice.
Signature:- ________________________________
Name:- DR._________________________________
S/O, D/O, W/O ______________________________
Phone No. (Res). ___________________________
Mobile No. _______________________________
Address:- __________________________________

House Officer Application Perfoma

Uploaded by

Copyright:

Available Formats

House Officer Application Perfoma

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

House Officer Application Perfoma

Uploaded by

Copyright:

Available Formats

SHEIH ZAYED HOSPITAL RAHIM YAR KHAN

APPLICATION FORM FOR HOUSE JOB

Signature of the Applicant

Official Use Only

I Dr. _________ S/O, D/O, W/O _, House Officer,

1. I will not take part in any association / Union.

You might also like