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Application Form

Application Number:

37801018

PUNJAB PUBLIC SERVICE COMMISSION,LAHORE

1.Post Applied For:

DENTAL SURGEON / DEMONSTRATOR / REGISTRAR

2.Advertisement Number:

25/2015

3.Case Number:

77E2015

4.Bank Receipt Date:

09-07-2015

5.Amount:

300

6.Bank :

SBP

7.Candidate's Name:

SANA NOOR

8.Father's Name:

NOOR MUHAMMAD

9.Postal Address:

HOUSE NO 719 GALI NO 74, SECTOR G-10/4 ISLAMABAD

10.Gender:

FEMALE11.CNIC NO:

12.Religion:

MUSLIM

14.DOB:

16-05-1987

15.Age ( on Closing Date):

16.Phone No:

92

17.Mobile Number:

19.Domicile:

MULTAN

3630483438914

13.Marital Status: MARRIED

13(i). Spouse Name:

MUHAMMAD
RASHID

HAROON

28 Year(s) 1 Month(s) - 23 Day(s)

03340727199 18.E-mail:

20.Do you claim to be a Disabled Person? NO 20(i).If yes, then type of disability:

dr.sananoor15@gmail.com

NO

20(ii). If Blind, then Examination Mode:

NO

20(iii). Disable Certificate Ref. No.

21. Punjab Government Employee?

NO 21(i) If yes, then Length of service

0 Year(s) 0 Month (s) 0 Day (s)

21(ii). Obtained NOC From Employer?

22.Retired / Released
Forces Person?

Armed

NO 22(i). If yes, then Length of service

0 Year (s) 0 Month (s) 0 Day (s)

22(ii). Convicted by Court Martial?

23.Ever Dismissed from Government / Autonomous body ?

NO

NO

23(i). If yes, Produce original certified documents from

concerned departments at the time of interview , if called for

24. Do you Claim additional marks as an unemployed child of a Punjab

Government Servant who was incapacitated or died while in service?
25. Ever been Convicted by Court in Pakistan?

NO

NO

24(i). Father / Mother CNIC No:

NO

25(i). If yes, produce detail at the time of interview, if called for

26. Are you facing any Criminal Trial in any Court of Pakistan? NO

26(i) If yes, produce detail at the time of interview, if called for

27.PMDC / OEC / PCATP / PBC NO :

27(i). Registration Expiry Date: 31-12-2017

13596-D

28. Written Test / Examination / Interview Centre:

RAWALPINDI

29. PHYSICAL STANDARD (FOR UNIFORM POSTS ONLY):

HEIGHT
CHEST NORMAL
EXPANDED
DISTANT VISION LEFT
DISTANT VISION RIGHT
VISION

NEAR VISION LEFT

NEAR VISION RIGHT

30. ACADEMIC QUALIFICATIONS:

CERTIFICATE/DEGREE

BOARD /

SUBJECTS

UNIVERSITY
MATRICULATION

B.I.S.E MULTAN

SCIENCE

RESULT
DECLARED

EXAMINATION

OBTAINED

TOTAL

%AGE /

ON

SYSTEM

MARKS

MARKS

GRADE

15-06-2002

ANNUAL

669

850

78.71

www.ppsc.punjab.gov.pk/(S(puu1zgdcmlqqmnnh3220ajab))/UsersReg/ApplicationPrint.aspx

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7/9/15

Application Form

INTERMEDIATE

B.I.S.E MULTAN

SCIENCE

20-08-2005

ANNUAL

883

1100

80.27

B.D.S

NISHTAR
MEDICAL
COLLEGE

DENTISTRY

05-06-2013

ANNUAL

528

800

66.00

31. SERVICE RECORD / EXPERIENCE (if required)

POST HELD

DEPARTMENT / OFFICE

STARTING DATE

ENDING DATE

SCALE

HOUSE OFFICER

NISHTAR INSTITUTE OF
DENTISTRY MULTAN

4/07/2013

3/07/2014

DISCLAIMER: I certify that all information in the Application Form submitted by me is correct and in case any infromation is
found to be incorrect, it will disqualify my candidature. I also certify that I have read all requirements / conditions of this post
along with the General Instructions in this regard.
Date: 09-07-2015

Candidate's Signature:

www.ppsc.punjab.gov.pk/(S(puu1zgdcmlqqmnnh3220ajab))/UsersReg/ApplicationPrint.aspx

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