Application Form

Diploma in Family Medicine

with an Integrated Postgraduate Certificate Course in Mental Health and Research for Universal Health Coverage (UHC)
Application Form
Name (as per National Identity Card or Passport)*

PrefixFirst NameLast Name
CNIC Number*
CNIC : 00000-0000000-0
Mobile Number*
+92-123-0000000
Father Name*

PrefixFirst NameLast Name
Email*
example@example.com
City*
Please let us know if you are applying for

Diploma in Family Medicine onlyBoth the Diploma in Family Medicine and the integrated Postgraduate Certificate Course in Mental Health and Research for Universal Health Coverage (UHC).
If you apply for both the diploma and the integrated postgraduate certificate course, you will be eligible for a fee scholarship

Application Form
Important Instructions

Step 1: Fill out and submit the scanned version of the following registration form.
Step 2: Please upload the attested copies of the following documents:
1. CNIC
2. One passport-size photo (Do not attest, overwrite or stamp the photograph.)
3. Matric Certificate
4. FSC Certificate
5. MBBS Certificate
6. PMDC Certificate
Step 3: To qualify for scholarship, please sign and upload the below deed agreement.
CNIC *

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One passport-size photo (Do not attest, overwrite or stamp the photograph.)*

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Matric Certificate*

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FSC Certificate*

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MBBS Certificate*

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PMDC Certificate*

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Scanned Version of the Registration Form*

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Scanned Version of the Deed Agreement*

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Should be Empty: