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Punjab Rangers Teaching Hospital
33 - Zarar Shaheed Road, Lahore
+92-42-36637004
info@prth.com.pk
Punjab Rangers Teaching Hospital
ISO 9001:2015 Certified | Lahore
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Punjab Rangers Teaching Hospital
House Job Form
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House Job Form
House Job
APPLICATION FORM FOR HOUSE JOB / FOUNDATION YEAR
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Name
*
First
Last
Father's Name / Husband Name
*
NIC Number
*
PMDC Provisional Registration Number
Passport Number (Foreigners)
Blood Group
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A+
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O+
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AB+
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Nationality
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Religion
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Email Address
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Institute From Where MBBS Degree
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Telephone Res
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Present Address
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Permanent Address
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Bank Account Number
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Professional
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Marks Obtained
*
Total Marks
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Percentage (%)
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Year of Passing
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2013
2014
2015
2016
2017
2018
2019
2020
2021
Attempt(s) :
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1
2
3
4
5
Professional
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Marks Obtained
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Total Marks
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Percentage (%)
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Year of Passing (copy)
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2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Attempt(s) :
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Professional
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Marks Obtained
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Total Marks
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Percentage (%)
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Year of Passing
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2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Attempt(s) :
*
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1
2
3
4
5
Professional
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Marks Obtained
*
Total Marks
*
Percentage (%)
*
Year of Passing
*
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2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Attempt(s) :
*
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1
2
3
4
5
Professional
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Marks Obtained
*
Total Marks
*
Percentage (%)
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Year of Passing
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2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Attempt(s) :
*
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1
2
3
4
5
Rotation Preference
*
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Medicine & Allied
Surgery & Allied
Surgery & Allied
*
Surgery
Gynae & Obstetrics
Anaesthesia
ENT
Eye
Orthopedics
Neurosurgery
Urology
Radiology
Medicine & Allied
*
Mediciine
Paediatrics
Psychiatry
Dermatology
Rotation Preference
*
Select
Medicine & Allied
Medicine & Allied
*
Mediciine
Paediatrics
Psychiatry
Dermatology
Rotation Preference
*
Select
Surgery & Allied
Surgery & Allied
*
Surgery
Gynae & Obstetrics
Anaesthesia
ENT
Eye
Orthopedics
Neurosurgery
Urology
Radiology
Hostel Accommodation Facility
*
Required
Not Required
Declaration
*
I have read and agreed to the Terms of Service Agreement listed below.
I personally, do solemnly declare that the information given by me in this application form is true and correct to the best of my knowledge and belief and I agree on the following terms and conditions for selection as house Officers in Punjab Rangers Teaching Hospital, Lahore.
1. Facts given above will serve as the basis for determination of my eligibility by the concerned authorities. My candidature so determined by the board/authorities will stand provisional until it is verified with the original certificates at the time of interview.
2. I will not claim benefit of any information which is not mentioned in the application form and is produced later on.
3. I also understand that after the submission of application, if my application stands incomplete, wrongly filled, unsigned or misstated in the above replies, disciplinary action shall be taken against me under the rules.
4. I undertake to complete the house job in accordance with PMDC Regulations in case of selection as an internee house surgeon/physician
5. I declare that I have not been already employed anywhere for house job and I am submitting my application through proper channel and I will ensure that I shall resign from my existing post (if any) when selected.
6. That I will immediately vacate the allotted Doctor’s hostel accommodation after the job is completed / terminated.
7. I will stay at hospital and will be available for duty round the clock and will not leave the hospital.
8. I will deposit a sum of Rs 10,000/- as security with the cashier of the hospital, which shall be refundable on-completion of the job. In case of non-completion and nonattendance, it will disqualify me for the loss of security as well as the house job certificate.
9. I will not make or take part in any association, unions or subversive activities i.e. strikes, demonstrations for slogans, and even instigation to someone etc. if found involved and guilty, my house job shall be liable to the termination / fines etc as per rules / regulations.
10. If any disciplinary action is taken by the administration after consideration it shall be final and I will not challenge it.
11. I will be bound to obey rules and regulations issued by the authorities from time to time.
12. I accept the above mentioned conditions for the consideration of my house job at Punjab Rangers Teaching Hospital, Lahore.
13. I have also read the rules and regulations.
Submit