Sharif Post Graduate Medical Institute
Sharif Medical City, Ph: 042-37860163, Date: ____________________
Email: spgmi@[Link]
Induction of Post Graduate Resident
(FCPS/MCPS/MD/MS)
Session January – 20222
Name: __________________________D/S/o__________________________________
❖ Required Documents:
Check List
Sr.
Content Check List
No.
1 Two Passport size photographs (blue/white back ground)
2 Duly filled Application form
3 Fee Challan form (Rs. 50/-)
4 CV
5 CNIC (attested copy)
6 Matric certificate / Marks Sheet (attested copy)
7 [Link] certificate / Marks Sheet (attested copy)
8 DMC - All professional examinations (attested copies)
9 Valid permanent PM&DC / PMC Registration (attested copy)
Letter of congratulations (for FCPS PGR applicants only)
10
JCAT Result Sheet(for MS / MD Program)
11 Domicile (attested copy)
12 House job certificate (attested copy)
13 Experience letters
14 Copy of research publications (indexed medical journals only)
__________________
Applicant’s Signature
SHARIF MEDICAL CITY
SHARIF POST GRADUATE
Jati Umra, Raiwind Road, Lahore SHARIF MEDICAL CITY HOSPITAL
MEDICAL INSTITUTE, LAHORE Tel: 042-37860101-4, UAN: 111-123-786,
Fax (SMCH): 042-37860105 (SPGMI): 042-37860163
E-mail: [Link]@[Link]
APPLICATION FORM
TRAINING PROGRAM POST GRADUATE RESIDENT
(FCPS/MCPS/MS/MD)
Training Program Applied for:_____________________
1. Name: ____________________________________________________________ PHOTOGRAPH
2. Father's / Husband’s Name __________________________________________
3. Age ___________________4. Date of Birth________________ 5. Blood Group_______________
6. CNIC - - 7. Gender Male Female
8. Marital Status _____________________________________ 9. Religion ____________________
10. Residential Address: ____________________________________________________________________
11. Permanent Address _____________________________________________________________________
12. Contacts (Parent / Spouse) ______________Cell No. (Self) __________________Email__________________
13. Valid PM&DC / PMC. No__________________________ Expiry Date: ____________________________
14. Academic Record
Year of Percentage /CGPA
Qualification Institution Name
Qualification /Grade
Matric/equivalent
Intermediate
Professional Exams
Graduation Year of (Marks Obtain/Total Marks)
Institution
(MBBS/BDS) Graduation 1st Prof. 1st Prof. Final
2nd Prof 3rd Prof.
Part 1 Part 2 Prof
Annual Annual Annual Annual Annual
Supple Supple Supple Supple Supple
/ / / / /
Exam Year of Passing No. of Attempt
FCPS-I / JCAT
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15. Distinctions/Awards (if any) during academic career: __________________________________________
16. House Job:
Sr Discipline / Duration
Hospital / Institution
# Department From To
1
3
4
Total Duration of House Job: ____________________________________________________________
17. Relevant Experience / Employment Record
Starting Ending
Organization Designation Reason (s) of Leaving
Date Date
Total Relevant Experience (excluding House Job) ______________________
18. Professional achievements (if any) _________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
19. Publications (Indexed Medical Journals only)
Case Report Research Article
Sr.# Name of the Journals Topic Author Positions
Total Publications ____________________________________________________________________
Any research work under progress ___________________________________________________________
I certify that the information provided by me in this Application Form is true, complete and correct to the
best of my knowledge.
Name of Applicant Applicant’s Signature
Date:
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