UNIVERSITY OF THE PUNJAB

ADMISSION FORM FOR BACHELOR OF MEDICINE AND BACHELOR OF SURGERY (M.B.,B.S.)

Please read the instructions carefully. Fill in your own handwriting (with blue ballpoint, without cutting, overwriting and fluid)
all the relevant information, provided in this form and attach all the required documents. Incomplete form will be rejected.

1. Category: Mention in which Professional you are appearing : Annual / Supplementary 20

Regular/Late College (I,II,III or Final)

2. Registration No.
(Punjab University) Gender: ..................................
(Male/Female)
3. Name of Candidate
(Block Letters)
Roll No: ..................................
(For Office Use)

4. N.I.C. No.

5. Father’s Name
(Block Letters)
Paste Photograph
(Passport Size)

6. Father’s N.I.C. No.

7. Present Address * Without attestation
(For correspondence)

* Light blue background

Permanent District Date of Birth

(As Per Matric Certificate)

Nationality Religion

8. Name of the Institution

9. Name of Centre (This column must be filled)

(At which to appear)

10. Mention Subject/s in which to appear:- Thumb Impression

1. 4.

2. 5.

3. 6.

11. Fee Information:

Amount.............................. Bank Challan No................................... Date.............................................

Branch Name..........................................................................................................................................
12.Previous Examination Information:
Examination Year of Examination Passed as
Roll No. Marks Division Board / University
Passing Annual/Supp. full/by Parts
F.Sc. Medical/Organic Chemistry

M.B.,B.S 1st Prof. Part I

M.B.,B.S 1st Prof. Part II

M.B.,B.S 2nd Professional

M.B.,B.S 3rd Professional

13. For Exemption / Compartment Candidate Only: Paste Photograph

(Passport Size)
Year of appearing in ............................... Professional (M.B.,B.S.) Annual or Supplementary
(I,II,III, Final)

Examination, 20 ................, held in ......................., under Roll No. ........................ Subjects in which failed
.............................................................................................................................................................................. * Attested from front
I hereby declare that all the particulars are correct and that in case of any difficulty arising out of inaccuracy therein,
I shall be responsible for the consequences. I have attached all the required documents. * Light blue background

Signature of the Candidate:........................................................ Permanent Address:...............................................

........................................................................................................................................................................................
(Permanent Address must be written, otherwise form will be rejected.)

I certify that the applicant is of good moral character has attended not less than two-thirds of the full course of lectures in each of the
subject of this examination has satisfactorily performed the work of the class has attended not less than two-thirds of the period assigned to
practical work in the Science subject/s offered by him/her of this examination has fulfilled the conditions laid down under the statues enforce in the
year of examination and has further continued to be on the roll of College affiliated to the faculty in Medicine and has persued an approved course
of study has filled and signed the admission form in my presence and the particulars filled in him/her are correct.

(Name of the Principal)

N.I.C. # :
Signature and Office Stamp
2

IMPORTANT INSTRUCTIONS

1. The Admission form will be liable to be cancelled if correct Registered No. is not mentioned or if incomplete or incorrect entry is
made in the Form. The incomplete Admission Form shall be rejected and returned forthwith. The University shall not take any
responsibility for the consequences.
2. Each candidate (Male/Female) must paste two latest Identical passport size photographs, (with sky blue background) at the
specified places of the Admission form.
3. The Examination begins on the dates as given in the date-sheet. Every candidate must keep his/her National Identification
Card with him/her in the Examination Hall while taking the Examination.
4. The Admission form will be entertained only if the attested photo-copy of the Registration card issued by the University is
attached with the form alongwith other documents.
5. Un-authorized change of centre is strictly prohibited. If any one changes his/her centre of Examination unfairmeans case
shall be registered against such a candidate.
6. No one should appear in the Examination without getting his/her genuine Roll Number Slip. Unfairmeans case shall be
registered against those who will violate the above or such other instructions as are issued.
7. The order in which the candidates are seated will be forwarded to the Examiner. As and when a candidate be discovered to
have copied from another, he/she will be externed from the Examination as well as the candidate from whom he/she copied if
There is reason to suppose that the copying was conceived at by the latter.
8. No candidate, without special permission of the Officer-in-charge shall leave his/her seat or the Examination room till the
end of the Examination. No candidate shall speak without permission if it be necessary for the candidate to communicate
with the Superintendent, he/she shall stand up in his/her place and the Officer-in-charge will see to his /her wants.
9. Before beginning his/her answer, each candidate shall write on the title page of his/her answer-book the following viz, the
subject, the number of the paper, and his/her Roll No. When the time allowed has expired the answer-book must be delivered
to the Superintendent, even though the candidate may not have answered any part of the paper.
10. No candidate shall give any mark of identification including his/her Roll Number, Name of College or Centre of
Examination in his/her answer-book except at specified places. Such candidates shall also be proceeded against under the
University Regulations.

Note: Examination fee through Money Orders, Postal Orders, Bank Drafts and Cheques shall not be accepted.