Registration Form (Diploma Programs)

Form should be filled in BLOCK letters. Please read the instructions in the admission policy before filling.

Applicant shall pay Rs. 100/- at the time of submission.

Diploma Course

#	Course	Duration
1	Anesthesia Technology	2 Years
2	Cardiology Technology	2 Years
3	Health Technology	2 Years
4	Pathology Technology	2 Years
5	Dental Technology	2 Years
6	Radiology Technology	2 Years
7	Surgical Technology	2 Years

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Photograph
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Please write your three (3) preferences from the above programs:

1st:

2nd:

3rd:

Personal Information

Applicant's Name

Applicant's CNIC (Fill in Capital Letters)

Father's Name

Father's CNIC

Date of Birth

Day

Month

Year

Gender

Male

Female

Marital Status

Single

Married

Permanent Address

Phone (Res.)

Cell

Guardian Information

Guardian Name

Guardian Profession

Guardian Contact No.

Experience in Medical Profession?

Yes

Marks Obtained in Matric Subjects

Biology

Physics

Chemistry

Educational Background

#	Name of Institution	Name of Degree / Diploma / Certificate	Obtained Marks	Total Marks	Passing %

Facilities Required

Do you want to avail Hostel facility?

Yes

Do you want to avail Transport facility?

Yes

Declaration

I,
S/o & D/o

do hereby solemnly declare that the particulars given above are correct.
In case of any wrong information of facts, I shall be responsible for the consequences.
I further undertake to abide by all the rules and regulations of the institute
and shall accept all the decisions made by the institute's administration.

Diploma Online Admission Form

Registration Form (Diploma Programs)

Diploma Courses