Reg. No.

REGISTRATION FORM

To be Filled by NTS

Federal Medical &

Dental College Islamabad

NTS

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Shaheed Zulfiqar Ali Bhutto Medical University

PIMS, G-8/3, Islamabad
MBBS Admission Test
Session 2015-16

01. Bank Online Deposit

700/-

of Rs:

from Designated Bank Branches.

Bank Code

Deposit Date

*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy)

02. Desired Test City: Fill Only One Box (Mandatory)

(Subject to a minimum of 200 candidates, other wise the candidates will be assigned next nearest test city)

01.

Islamabad / Rwp

02.

Lahore

03.Multan

04.

Faisalabad

05.

Bahawalpur

06.

Karachi

07.

Hyderabad

08.

Sukkur

09.

Abbottabad

10.

Peshawar

11.

D.I. Khan

12.

Quetta

03. Province of Domicile: Fill Only One Box for Desired Province Domicile. (Mandatory)
01.

Federal Capital Territory

05.

Sindh (Urban)

09.

FATA

Personal

Information:

02.

Punjab

03.

Sindh (Rural)06.

07.

Khyber Pakhtunkhwa

AJK

08.

04.

Balochistan

Gilgit Baltistan

Use CAPITAL letters and leave spaces between words.

04. Name in Full:

05. Fathers Name:
06. Candidate CNIC #:
Write your own CNIC No. Or B Form No.

07. Gender:

Male

08. Date of Birth:

Female

D M

09. Postal Address:

All correspondence will be made on this address though courier service or ordinary postal service.

City:
10. Phone No: (OFF)
City Code - Phone No

(RES.)

11. Is your Father or Mother Federal Government Employee?

District:
(Mobile)

Mandatory

Yes

Write your Correct Date of Birth

otherwise you will be rejected

No

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