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MBBS 4th Prof Examination form

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Elaska Dawn
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8 views

MBBS 4th Prof Examination form

Uploaded by

Elaska Dawn
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FOURTH PROFESSIONAL MBBS (04)

KHYBER MEDICAL UNIVERSITY


PESHAWAR Roll No__________

EXAMINATION ADMISSION FORM


FOURTH PROFESSIONAL MBBS Paste photo

Annual/ Supplementary 20______ graph attested


on face side
First Professional MBBS R.No._________ A/S_______Session_________Marks_______

Second Professional MBBS R.No._________ A/S______Session_________Marks______

Third Professional MBBS R.No. _________ A/S ______ Session_______ Marks________ (Attach DMC)

University Registration No.

College Name:

1. Name (IN BLOCK LETTERS) _____________________________________Gender______________

2. Father’s Name (IN BLOCK LETTERS)___________________________________________________

3. CNIC No. - -

4. Permanent address_________________________________________________________________

________________________________________________________ Phone No___________________

5. Passed 3rd Professional MBBS Annual/Supply under Roll No. ___________ Session____________

6. Appeared last time 4th Professional Annual/Supply Examination under Roll No_____________
Session________________ (Attach DMC).
7. Subjects in which to be appeared:

i. Special Pathology ii. Community Medicine

iii Eye iv. ENT

DECLARATION
I hereby solemnly declare that the particulars given above are correct .In case of any wrong information or
concealment of facts I shall be responsible for the consequences. Further, I undertake to abide by the
Rules and Regulations of Examination prescribed by the Khyber Medical University, Peshawar.

Dated_______________ Signature of Candidate_________________

FOR OFFICE USE ONLY

Entries and result checked He/She is Eligible/Ineligible Allowed/Disallowed


and found correct.

Dealing Assistant/Supdt: ACE DCE


Remarks (if any)
CERTIFICATE
1. I certify that the candidate has fulfilled the conditions laid down in the rules, that he/she is of good
moral character; that he/she has signed this application: and his/her particulars over-leaf are
correct.
2. I certify that he/she completed the course of lectures, practical, demonstrations, clinical work
etc.as prescribed in the regulations.
3. I certify that he/she has passed the 3rd Professional ….……... (Annual/Supply) Examination and
is eligible to appear in the 4th Professional Examination.
4. He/She has remitted Rs…………. (Rupees in words) ………………………………........……..…..
………………………………………………………………………………….…………………………..
Vide Bank Draft No……………………..….Dated……………………..……..as
Examination Admission Fee (attached).

Note: - All documents including Bank Draft to be attached here.

Principal

Signature __________________________________

Name of College ____________________________

Office Seal _________________________________

===============================================================================

INSTRUCTIONS : (TO BE READ CAREFULLY)


1. Examination Admission Form duly completed in all respects should reach the controller of
Examinations, Khyber Medical University Peshawar on or before the last date notified for the purpose
failing which late fee will be charged.
2. Fee once deposited is neither refundable nor adjustable if the candidate is otherwise eligible.
3. Two different Examinations are not allowed in one session of examination.
4. Incomplete forms will not be entertained.
5. All candidates are required to attach three copies of passport size photographs and one copy of
National Identity Card /Domicile Certificate duly attested by the principle concerned.
6. Incomplete /unsigned forms will not be entertained and will be returned at the cost/risk of the
candidate.
7. Admission fee remitted through money order/cheque will not be accepted.
8. No student is eligible for a university examination without having attended 75% of the lectures,
demonstrations, tutorials, and practical or clinical work both inpatient and outpatient.
9. Whatever may be the system of marking, for all examinations throughout the medical course the
percentage of pass marks in each subject will not be less than 50% i.e., 50% in theory and 50% in
practical
10. No grace marks are allowed in any examination.

Student Signature _________________


KHYBER MEDICAL UNIVERSITY
PESHAWAR Roll No_____________
Annual/Supplementary Examination 20_____
SUPERINTENDENT SLIP
(TO BE FILLED IN BY THE STUDENT)
[To be retained by Suptd. & returned to the Paste photo
Exam. Section after termination of exam] graph attested
on back side
University Registration No.

CNIC No. - -
Admit Mr./Mrs./Miss

Son/Daughter of

Of the __________________________________________________________ College for MBBS 4th Professional

Examination on the dates as given in the date sheet to the Centre for Examination at ________________________

____________________________________________________________________________________________

Subjects In which to be examined

1. __________________________ 2. _________________________________

3. ____________________________ 4. _____________________________________

Deputy Controller of Examinations


Khyber Medical University
Peshawar.
___________________
Signature of Candidate

KHYBER MEDICAL UNIVERSITY


PESHAWAR Roll No_____________

Annual/Supplementary Examination 20_____


STUDENT SLIP
(TO BE FILLED IN BY THE STUDENT) Paste photo
graph attested
[To be retained by the Candidate]
on back side
University Registration No.

CNIC No. - -

Admit Mr./Mrs./Miss

Son/Daughter of

Of the __________________________________________________________ College for MBBS 4th Professional

Examination on the dates as given in the date sheet to the Centre for Examination at ________________________

____________________________________________________________________________________________

Subjects In which to be examined

1. __________________________ 2. _________________________________

3 __________________________ 4. ________________________________

Deputy Controller of Examinations


Khyber Medical University
Peshawar.
Signature of Candidate

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