REGISTRATION FORM

Reg. No.
To be Filled by NTS

NTS

Medical Officer, Health Department

Govt. of Khyber Pakhtunkhwa
Recruitment Test

Picture 1
Paste your
recent
passport size
color photograph
with gum

Eligibility Criteria:
A. Is your Age according to the desired Post at the date of 02-02-2015?

Yes

No

B. Is your Education is as per required Qualification as mentioned in Advertisement?

Yes

No

C. Have you already completed your House Job Traning?

Yes

No

D. Do you have Permanent / Valid / Provisional PMDC Registration?

Yes

No

E. Are you Domiciled in Khyber Pahkhunkhwa / FATA?

Yes

No

If your reply is Yes to A, B, C, D & E above, only then please proceed further. Otherwise you are not eligible to apply.

1. Bank Online Deposit of Rs: 400/- from Designated Bank Branches.

Deposit Date

Bank Code

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

2. Test City:

Peshawar

Personal Information: Use CAPITAL letters and leave spaces between words.
03. Name in Full:
04. Fathers Name:
05. Candidate CNIC# :

06. Gender:

Mandatory (Write your cnic no also

attached the photocopy of your CNIC.
Other wise you are not eligible)

07. Date of Birth:

1 9

Write your Correct Date of

Birth as per your CNIC

Male

08. Email:

09. Postal Address:

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

City:
10. Phone No: (OFF)

District:

(RES.)

(City Code - Phone No)

(Mobile)
Mandatory

11. Are you a Government Servant?

Yes

No

If Yes then total years of continous experience:

If yes, please attach NOC from the concerned department.

12. Do you belong to Minorities?

Yes

No

13. Name of Spouse (in case of Government Servant)?

14. Designation with place of posting of spouse?
15. PMDC Registration No. (Provisional Registration is accepted)?
D

16. Date of completion training:

Female

17. District of Domicile: Fill Only One Box

District Code

District Name

(Mandatory)

District Code

District Name

District Code

District Name

301

Abbotabad

302

Bannu

303

Battagram

304

Buner

305

Charsadda

306

Chitral

307

Dera Ismail Khan

308

Hangu

309

Haripur

310

Karak

311

Kohat

312

Kohistan

313

Lakki Marwat

314

Lower Dir

315

Malakand

316

Mansehra

317

Mardan

318

Nowshera

319

Peshawar

320

Shangla

321

Swabi

322

Swat

323

Tank

324

Tor Ghar

325

Upper Dir

326

FATA

18. Please also Write the District adjustment to your District amongst the advertized District,
you are willing to work there:
Write District Code & District Name according to the District Code & District Name written above in District of Domicile.

Preference

District Code

District Name

Preference 01
Preference 02

19. Write Your Exact Zone as per your domicile:

Detail is given at the Last Page. Mandatory

ZONE:

20. Academic Information: (Please attach attested copies of your academics)

Note: 1. NTS will not issue Roll No Slips to those who have not filled in their academic record properly.
2. Candidate should convert their grades into marks. (O Level / A Level or any other degree having grade).
3. Write exact degree name & major subject mention in certificate / transcript.
4. Result awaiting candidates are not eligible.
Certificate /
Degree Name

Degree Title

Year
Passing

Major Subject

Obtained
Marks/CGPA

Total
Marks/CGPA

Board / University / Country

Matric
(10 Years)

Intermediate
(12 Years)

Bachelor
(14 Years)

MBBS /
Equivalent
Qualification
MBBS /
Equivalent
Qualification
(In case of abroad)

Higher
Qualification
(If Any)

Degree
Name

MBBS
(from
Pakistan)

First Professional
Obtained Marks

Total Marks

Second Professional
Obtained Marks

Total Marks

Third Professional
Obtained Marks

Total Marks

Final Professional
Obtained Marks

Total Marks

21. Relevant Experience:

Job Duration
Sr #

Name of the Organization / Department

Designation

Write only Month & Year

From

To

1.
2.
3.
Months

Years

22. Total Job Experience:

Check List:
Copy of Your CNIC
2 recent Passport Size Color Photographs to be attached in the picture box area
Original Bank Deposit slip NTS copy
Attested copies of Educational Documents / Relevant Experience (If any).
Copy of PMDC Registration

Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do
hereby solemnly affirm that I have read and understood the conditions for appearing in the
NTS Test and that I have filled the form as per instructions given above and in the event any
information contained herein is found to be untrue at any level, I shall be liable to
disciplinary action which may result in cancellation of my candidature.

Date: ________________

Signature of the Candidate__________________

Picture 2
Affix your
recent
passport size
color
photograph
with Stapler

By Hand submission of Application Form is not allowed.

Mobile Phones are not allowed in Test Center premises.

nd
Last date for application submission is Monday 2 February 2015.

Application should reach NTS office latest by last date of submission of Application Form.

NTS will not be responsible for late receiving of application through courier / Pakistan Post etc.

rd
Applications received on Tuesday 3 February 2015 will not be entertained by NTS.

Help line:
UAN. +92-51-844-444-1
Website:

www.nts.org.pk

Please Send Application Forms to:

Health Department KP (Project)
National Testing Service
1-E, Street No. 46, I-8/2,
Islamabad.

The Province is divided into five zones comprising the area listed below:Zone-1:
Agencies of bajaur, Mohmand, Khyber, Kurram, Orakzai, North Waziristan, South Waziristan and
Frointier Regions attached to the Districts of Peshawar, Kohat, Bannu and Dera ismail Khan.
Zone-2:
Districts of Peshawar, Charsadda, Nowshera, Swabi and Mardan.
Zone-3:
Districts of Swat, Buner, Dir, Chitral, Kohistan, Shangla Par and Malakand Areas (Swat Ranizai and
Sam Ranizai and backward areas of hazara Division i.e. (1) Ilaqa Upper Tanawal composed of
Darband Area f Tehsil Haripur and Shergarh area of District Mansehra and (2)merged Areas
composed of Battagram including Hill Nilshang and Thakot, Allai Kaya Khabbal and Gadoon Area.
Zone-4:
Districts of Dera Ismail Khan, Tank, Bannu, Lakki Marwat, Kohat and Karak.
Zone-5:
Districts of Haripur, Abbottabad, Mansehra excluding their backward areas included in Zone-3.

National Testing Service-Pakistan

National Testing Service-Pakistan

Building Standards in Educational and Professional Testing

Building Standards in Educational and Professional Testing

Date:

Branch Code:

Date:

Branch Code:

Branch Name:

Branch Name:

ONLINE DEPOSIT SLIP

(* Please deposit fee in only one bank & tick the relevant bank)

Muslim Commercial Bank

Allied Bank Limited

Muslim Commercial Bank

Allied Bank Limited

(Formely: Allied Bank of Pakistan Limited)

(Formely: Allied Bank of Pakistan Limited)

Remote
I-8 Markaz Branch Islamabad (0140947)
Branch:
A/C
A/C
Title: NTS-Pakistan-Collection No. 0010008325640018

Remote
Branch:
A/C
Title:

I-8 Markaz Branch, Islamabad (1501)

A/C
No.

Remote
I-8 Markaz Branch Islamabad (0140947)
Branch:
A/C
A/C
Title: NTS-Pakistan-Collection No. 0010008325640018

Remote
Branch:
A/C
Title:

I-8 Markaz Branch, Islamabad (1501)

Note: Bank Service Charges Free of Cost

A/C
0041749181000999
No.
Note: Bank Service Charges Free of Cost

Remote H9 Shalimar Recording Co ISB (1742)

Branch:
A/C
A/C
No. 1742-79002786-03
Title: NTS-Collection

Remote
Branch:
A/C
Title:

Remote H9 Shalimar Recording Co ISB (1742)

Branch:
A/C
A/C
No. 1742-79002786-03
Title: NTS-Collection

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

0041749181000999
Note: Bank Service Charges Free of Cost

Remote
Branch:
A/C
Title:

NTS-Collection

NTS-Collection

LTD

LTD

THE POWER TO LEAD

Cantt Br Kashmir Road Rawalpindi (0041)

NTS- Pakistan

A/C
No.

217767828

Note: Bank Service Charges Free of Cost

THE POWER TO LEAD

*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original
Deposit Slip (NTS Copy) along Application Form to NTS Office
a
Application Form will not be entertained without Original Deposit Slip (NTS Copy)

Cantt Br Kashmir Road Rawalpindi (0041)

NTS- Pakistan

Father
Name:

Father
Name:

CNIC No/
B Form No:

CNIC No/
B Form No:

Applicant Signature

Amount in
word: Rs.

Four Hundred Rupees Only

Amount
Rs:

Non Refundable/ Non Transferable

Cashier
(Health Department (Medical Officer) 02-02-2015)

Officer

Note: Bank Service Charges Free of Cost

1. Please Stamp both copies of deposit Slip.

2. The Bank Must Return NTS Copy to the Candidate.
3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.
Applicants
Name:

400/-

217767828

*Note:

Applicants
Name:

Amount
Rs:

A/C
No.

400/-

Applicant Signature

Amount in
word: Rs.

Four Hundred Rupees Only

Non Refundable/ Non Transferable

Cashier
(Health Department (Medical Officer) 02-02-2015)

Officer