Indus Medical College - Admission Form

NOTE: ** Incomplete and incorrect information will disqualify the candidate from the admission process. Once you enter the information it would not be editable. So, fill this form with concentration. **

Please pay Rs. 1000/= fee of admission form in the Bank. Bank Account Details are as follows:

Bank Name:	MCB BANK
Account Title:	Indus Medical College
Account Number:	0614902801002632
Branch:	Cantt Branch Hyderabad
Branch Code:	1223

(You can pay your admission form fee in any MCB branch all over Pakistan or Online Transfer via Debit/Credit Card, Easy Paisa, Jazzcash direct to the Bank Account Mentioned Above.).
** Enter the Payment Transaction Number in the Fee Payment Transaction Number Column.

Name:

WRITE YOUR FULL NAME IN BLOCK LETTERS,
AS MENTIONED IN MATRIC CERTIFICATE

Father's Name:

WRITE YOUR FULL NAME IN BLOCK LETTERS,
AS MENTIONED IN MATRIC CERTIFICATE

Surname/Family Name:

WRITE IN BLOCK LETTERS,
AS MENTIONED IN MATRIC CERTIFICATE

CNIC/Form-B Number:

WRITE YOUR (CNIC) NATIONAL IDENTITY CARD/FORM-B NUMBER, WITHOUT DASHES FROM NADRA

Date of CNIC issue:

Date of birth:

WRITE AS SHOWN IN YOUR MATRIC CERTIFICATE

Nationality:

Religion:

Place of Birth:

Gender:

Marital Status:

Domicile No:

District of Domicile:

Domicile Province:

Present Address:

City:

District:

Province:

Whatsapp no. for online classes:

Cell no 1:

Email address:

Cell no 2:

Fee Payment
Transaction Number:
(Deposit Slip Number,
Transaction Number of
Easy Paisa, Jazz Cash or
Credit Debit Card Payment)

Father / Guardian Name:	Surname: (IN BLOCK LETTERS)	CNIC no:
Office tel no:	City:	District:
E-mail address:	Cell no:	Residence Tel no:

Father / Guardian Name:

Surname:

(IN BLOCK LETTERS)

CNIC no:

Office tel no:

City:

District:

E-mail address:

Cell no:

Residence Tel no:

Passing Year:	Total Marks Obtained:	Obtained Percentage:
Marks of Physics:	Marks of Chemistry:	Marks of Biology:
Grade of Physics (O Level):	Grade of Chemistry (O Level):	Grade of Biology (O Level):
Name of board:	Name of school:

Passing Year:

Total Marks Obtained:

Obtained Percentage:

Marks of Physics:

Marks of Chemistry:

Marks of Biology:

Grade of Physics (O Level):

Grade of Chemistry (O Level):

Grade of Biology (O Level):

Name of board:

Name of school:

Passing Year:	Total Marks Obtained:	Obtained Percentage:
Marks of Physics:	Marks of Chemistry:	Marks of Biology:
Grade of Physics (A Level):	Grade of Chemistry (A Level):	Grade of Biology (A Level):
Name of board:	Name of school:

Passing Year:

Total Marks Obtained:

Obtained Percentage:

Marks of Physics:

Marks of Chemistry:

Marks of Biology:

Grade of Physics (A Level):

Grade of Chemistry (A Level):

Grade of Biology (A Level):

Name of board:

Name of school:

Roll no:		City:		Province:
Date of Test:		Result Score:		Result %:

Roll no:

City:

Province:

Date of Test:

Result Score:

Result %:

CANDIDATE PERSONAL INFORMATION

PARENTS INFORMATION

ACADEMICS QUALIFICATION

MATRIC/O'LEVEL DETAILS

INTERMEDIATE/A'LEVEL DETAILS

NATIONAL MEDICAL AND DENTAL COLLEGES ADMISSION TEST (MDCAT) OR ANY TEST CONDUCTED BY PMC