Sample Registration Form
A. Personal Information: Course: * AFNS-BSc Nursing Trained Nurse Testing Center: * ASRC Dera Ismail Khan ASRC Faisalabad ASRC Gilgit ASRC Hyderabad ASRC Karachi ASRC Khuzdar ASRC Lahore ASRC Multan ASRC Muzaffarabad ASRC Panoaqil ASRC Peshawer ASRC Quetta ASRC Rawalpindi
Name: *
CNIC/ Form-B: * (format xxxxx-xxxxxxx-x) Date of Birth: * (DD/MM/YYYY) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December e.g 1993
Father/Guardian Name: * Father/ Guardian CNIC: * (format xxxxx-xxxxxxx-x)
Address: *
Domicile: * Abbottabad Astore Attock Awaran Badin Bagh Bahawalnagar Bahawalpur Bajaur Agency Baltistan Bannu Barkhan Batgram Bhakkar Bhimber Bolan Buner Chagai Chakwal Charsadda Chitral Cholistan Desert Dadu Dera Bugti DG Khan DI Khan Diamir Dingarh Dir Drawer Fort Faisalabad Gawadar Ghanche Ghizer Ghotki Gilgit Gujranwala Gujrat Hafizabad Hangu Haripur Hyderabad Islamabad Jacobabad Jafarabad Jhal Magsi Jhang Jhelum Kalat Karachi Central Karachi East Karachi South Karachi West Karak Kasur Kech/Turbat Khairpur Khanewal Kharan Khushab Khuzdar Khyber Agency Killa Abdullah Killa Saifullah Kohat Kohistan Kohlu Kotli Kurram Agency Lahore Lakki Marwat Larkana Lasbela Leiah Lodhran Loralai M B Din Malakand Malir Mansehra Mardan Mastung Mianwali Mirpur Mirpur Khas Mohemmend Agency Mojgarh Multan Musa Khel Muzaffarabad Muzaffargarh Nankana Sahib Narowal Nasirabad Naushahro Feroze Nawab Shah Nowshera NW Agency Okara Orakzai Agency Pakpattan Panjgur Peshawar Pishin Poonch Quetta Rahim Yar Khan Rajan Pur Rawalpindi Sahiwal Salamsar Sanghar Sargodha Shangla Sheikhupura Shikarpur Sialkot Sibbi Sudhnoti Sukkur SW Agency Swabi Swat T T Sing Tando Muhammad Khan Tank Tarparker/Mithi Thatta Tribal Areas adjoining Bannu Dist Tribal Areas adjoining D.I.Khan Dist Tribal Areas adjoining Kohat Dist Tribal Areas adjoining Lakki Marwat Dist Tribal Areas adjoining Peshawar Dist Tribal Areas adjoining Tank Dist Umerkot Vehari Zhob Ziarat Chiniot District: * Abbottabad Astore Attock Awaran Badin Bagh Bahawalnagar Bahawalpur Bajaur Agency Baltistan Bannu Barkhan Batgram Bhakkar Bhimber Bolan Buner Chagai Chakwal Charsadda Chitral Cholistan Desert Dadu Dera Bugti DG Khan DI Khan Diamir Dingarh Dir Drawer Fort Faisalabad Gawadar Ghanche Ghizer Ghotki Gilgit Gujranwala Gujrat Hafizabad Hangu Haripur Hyderabad Islamabad Jacobabad Jafarabad Jhal Magsi Jhang Jhelum Kalat Karachi Central Karachi East Karachi South Karachi West Karak Kasur Kech/Turbat Khairpur Khanewal Kharan Khushab Khuzdar Khyber Agency Killa Abdullah Killa Saifullah Kohat Kohistan Kohlu Kotli Kurram Agency Lahore Lakki Marwat Larkana Lasbela Leiah Lodhran Loralai M B Din Malakand Malir Mansehra Mardan Mastung Mianwali Mirpur Mirpur Khas Mohemmend Agency Mojgarh Multan Musa Khel Muzaffarabad Muzaffargarh Nankana Sahib Narowal Nasirabad Naushahro Feroze Nawab Shah Nowshera NW Agency Okara Orakzai Agency Pakpattan Panjgur Peshawar Pishin Poonch Quetta Rahim Yar Khan Rajan Pur Rawalpindi Sahiwal Salamsar Sanghar Sargodha Shangla Sheikhupura Shikarpur Sialkot Sibbi Sudhnoti Sukkur SW Agency Swabi Swat T T Sing Tando Muhammad Khan Tank Tarparker/Mithi Thatta Tribal Areas adjoining Bannu Dist Tribal Areas adjoining D.I.Khan Dist Tribal Areas adjoining Kohat Dist Tribal Areas adjoining Lakki Marwat Dist Tribal Areas adjoining Peshawar Dist Tribal Areas adjoining Tank Dist Umerkot Vehari Zhob Ziarat Chiniot
Postal Code: * Tehsil: *
Select Tehsil <select name="tehsil_id" id="tehsil_id" > <option value="">Select Tehsil</option> </select>
Gender: * Female Marital Status: Single Married Widow Separated Divorcee
Mobile Number: * Email: *
Appearence Status: Fresh Candidate
Appearance Status Information:
All candidates will be considered as fresh candidates for preliminary selection.
B. Educational Details: 1. Matric: Group: * Science O Levels Result_status: * Completed
Roll Number: * Passing Year: *
Marks Obtained: * Total Marks: *
Board: * Agha Khan University Examination Board Allama Iqbal Open University Balochistan Board of Intermediate & Secondary Education Quetta Board of Intermediate & Secondary Board of Hyderabad (Sindh) Federal Board of Intermediate & Secondary Education Islamabad The AJ&K Board of Intermediate and Secondary Education Mirpur (AK) The Armed Forces Board for Higher Education GHQ, Rawalpindi The Board of Intermediate & Secondary Education Abbottabad The Board of Intermediate & Secondary Education Bahawalpur The Board of Intermediate & Secondary Education Bannu The Board of Intermediate & Secondary Education Dera Ghazi Khan The Board of Intermediate & Secondary Education Dera Ismail Khan The Board of Intermediate & Secondary Education Faisalabad The Board of Intermediate & Secondary Education Gujranwala The Board of Intermediate & Secondary Education Karachi The Board of Intermediate & Secondary Education Kohat The Board of Intermediate & Secondary Education Lahore The Board of Intermediate & Secondary Education Larkana The Board of Intermediate & Secondary Education Malakand The Board of Intermediate & Secondary Education Mardan The Board of Intermediate & Secondary Education Mirpur Khas (Sind) The Board of Intermediate & Secondary Education Multan The Board of Intermediate & Secondary Education Peshawar The Board of Intermediate & Secondary Education Rawalpindi The Board of Intermediate & Secondary Education Saidu Sharif, Swat The Board of Intermediate & Secondary Education Sargodha The Board of Intermediate and Secondary Education, Sukkur (Sind) The Board of Intermediate and Secondary Education, Sahiwal The Board of Technical Education Peshawar (BTE) The Inter Board Committee of Chairman Government of Pakistan The Karakurum intermediate University Gilgit The Punjab Board of Technical Education Lahore The School of Electronics, Pakistan Air Force Korrangi Karachi The Sind Board of Technical Education, Karachi School/Institute: *
2.Intermediate Part-I:
Group: A Level F.Sc(Pre.Med) Result_status: Completed
Roll Number: Passing Year:
Marks Obtained: Total Marks:
Board: Agha Khan University Examination Board Allama Iqbal Open University Balochistan Board of Intermediate & Secondary Education Quetta Board of Intermediate & Secondary Board of Hyderabad (Sindh) Federal Board of Intermediate & Secondary Education Islamabad The AJ&K Board of Intermediate and Secondary Education Mirpur (AK) The Armed Forces Board for Higher Education GHQ, Rawalpindi The Board of Intermediate & Secondary Education Abbottabad The Board of Intermediate & Secondary Education Bahawalpur The Board of Intermediate & Secondary Education Bannu The Board of Intermediate & Secondary Education Dera Ghazi Khan The Board of Intermediate & Secondary Education Dera Ismail Khan The Board of Intermediate & Secondary Education Faisalabad The Board of Intermediate & Secondary Education Gujranwala The Board of Intermediate & Secondary Education Karachi The Board of Intermediate & Secondary Education Kohat The Board of Intermediate & Secondary Education Lahore The Board of Intermediate & Secondary Education Larkana The Board of Intermediate & Secondary Education Malakand The Board of Intermediate & Secondary Education Mardan The Board of Intermediate & Secondary Education Mirpur Khas (Sind) The Board of Intermediate & Secondary Education Multan The Board of Intermediate & Secondary Education Peshawar The Board of Intermediate & Secondary Education Rawalpindi The Board of Intermediate & Secondary Education Saidu Sharif, Swat The Board of Intermediate & Secondary Education Sargodha The Board of Intermediate and Secondary Education, Sukkur (Sind) The Board of Intermediate & Secondary Education Sahiwal The Board of Technical Education Peshawar (BTE) The Inter Board Committee of Chairman Government of Pakistan The Karakurum intermediate University Gilgit The Punjab Board of Technical Education Lahore The School of Electronics, Pakistan Air Force Korrangi Karachi The Sind Board of Technical Education, Karachi School/Institute:
3.Intermediate Part-II:
Group: A Level F.Sc(Pre.Med) Result_status: Completed Appearing In Exams Awaiting Result
Roll Number: Passing Year:
Marks Obtained: Total Marks:
Board: Agha Khan University Examination Board Allama Iqbal Open University Balochistan Board of Intermediate & Secondary Education Quetta Board of Intermediate & Secondary Board of Hyderabad (Sindh) Federal Board of Intermediate & Secondary Education Islamabad The AJ&K Board of Intermediate and Secondary Education Mirpur (AK) The Armed Forces Board for Higher Education GHQ, Rawalpindi The Board of Intermediate & Secondary Education Abbottabad The Board of Intermediate & Secondary Education Bahawalpur The Board of Intermediate & Secondary Education Bannu The Board of Intermediate & Secondary Education Dera Ghazi Khan The Board of Intermediate & Secondary Education Dera Ismail Khan The Board of Intermediate & Secondary Education Faisalabad The Board of Intermediate & Secondary Education Gujranwala The Board of Intermediate & Secondary Education Karachi The Board of Intermediate & Secondary Education Kohat The Board of Intermediate & Secondary Education Lahore The Board of Intermediate & Secondary Education Larkana The Board of Intermediate & Secondary Education Malakand The Board of Intermediate & Secondary Education Mardan The Board of Intermediate & Secondary Education Mirpur Khas (Sind) The Board of Intermediate & Secondary Education Multan The Board of Intermediate & Secondary Education Peshawar The Board of Intermediate & Secondary Education Rawalpindi The Board of Intermediate & Secondary Education Saidu Sharif, Swat The Board of Intermediate & Secondary Education Sargodha The Board of Intermediate and Secondary Education, Sukkur (Sind) The Board of Intermediate & Secondary Education Sahiwal The Board of Technical Education Peshawar (BTE) The Inter Board Committee of Chairman Government of Pakistan The Karakurum intermediate University Gilgit The Punjab Board of Technical Education Lahore The School of Electronics, Pakistan Air Force Korrangi Karachi The Sind Board of Technical Education, Karachi School/Institute:
4. Bachelors:
Group: Nursing Diploma/Midwifery BSc Generic Nursing Post(RN) BSc Nursing Result_status: Completed
Roll Number: Passing Year:
Marks Obtained: Total Marks:
OR
CGPA: (format x.xx)
University: Institute:
5. Other Qualification:
Qualification: Institute:
I hereby declare that to the best of my knowledge & belief the above information is correct. I realize that if any information given by me in this application form is false or incomplete or if any of the original educational certificate is found to have been tampered or mutilated or fake, my application will be rejected and I will be liable to any disciplinary action considered necessary by GHQ.
But sir I do not have my mother Cnic number
ReplyDeleteWo hmaray sath nhi rehti hn aur unka CNIC card bhi gum ho gya tha ab Meri mother ka Cnic card nhi ha but is form may necessary ha plzz can you help me sir what I should do
ReplyDeletePlzz sir guide me about it
ReplyDelete30 last date ha admission ki plzz jaldi reply day sir what I should do about this issue
ReplyDelete