Application

Categories Applied For (Please tick only one) Renal Dialysis Technician Ophthalmic Technician Medical Lab Technician

Name of Applicant (In block letters)

Paste here one Passport size without attestation

Father’s Name (In block letters)

Student Date of Birth

Student CNIC/B Form Number (NADRA)

Student Father CNIC Number (NADRA)

Domicile District

PTCL #

Student Mobile Phone #

Student’s Father Mobile Phone #

Present Home Address

Permanent Home Address

Matric Total Marks Obtained Marks Percentage Science Subjects Marks Aggregate Percentage Science Subjects Physics Marks Chemistry Marks Biology Marks

FSC, FA Total Marks Obtained Marks Percentage