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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. Father’s 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:
D
D
M
M
Y
Y
Y
Y
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:
D
M
M
Y
Y
Y
Y
Female
17. Please also select the District adjustment to your District amongst the advertized District,
you are willing to work there:
Sr. No.
District Preference
18. District of Domicile: Fill Only One Box
(Mandatory)
01.
Abbotabad
02.
Bannu
03.
Battagram
04.
Buner
05.
Charsadda
06.
Chitral
07.
Dera Ismail Khan
08.
Hangu
09.
Haripur
10.
Karak
11.
Kohat
12.
Kohistan
13.
Lakki Marwat
14.
Lower Dir
15.
Malakand
16.
Mansehra
17.
Mardan
18.
Nowshera
19.
Peshawar
20.
Shangla
21.
Swabi
22.
Swat
23.
Tank
24.
Tor Ghar
25.
Upper Dir
26.
FATA
19. Write Your Exact Zone as per your domicile:
Detail is available at NTS website Mandatory
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
Major Subject
Year
Passing
Obtained
Marks/CGPA
Total
Marks/CGPA
Matric
(10 Years)
Intermediate
(12 Years)
Bachelor
(14 Years)
Bachelor /
Master
(16 Years)
MBBS /
Equivalent
Qualification
MBBS /
Equivalent
Qualification
(In case of abroad)
Higher
Qualification
(If Any)
1st Prof.
1st Prof.
2nd Prof.
2nd Prof.
3rd Prof.
3rd Prof.
Final
Final
Board / University / Country
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
Ø
By Hand submission of Application Form is not allowed.
Ø
Mobile Phones are not allowed in Test Center premises.
nd
Last date for application submission is Monday 2 February 2015.
Ø
Application should reach NTS office latest by last date of submission of Application Form.
Ø
NTS will not be responsible for late receiving of application through courier / Pakistan Post etc.
Ø
rd
Applications received on Tuesday 3 February 2015 will not be entertained by NTS.
Ø
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.
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.
Applicant’s
Name:
400/-
217767828
*Note:
Applicant’s
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