MERCY TEACHING HOSPITAL
Fill up cleanly in Block Letters Post Applied for: ____________
General Application Form (For Paramedic & Other Staff)
Name:__________________________________________ Age:_____________________________
Father’s Name:___________________________________ Marital Status:_____________________
Date & Place of Birth:______________________________ Husband Name:____________________
Nationality:_______________________________________ Contact Phone No:__________________
Permanent Address:________________________________________________________________________________
Present Address:__________________________________________________________________________________
________________________________________________________________________________
Details of Dependents: (Name, Age & Relation)
1 _______________________________ _________________________ _________________________
2 ______________________________ _________________________ _________________________
Languages you can conversant/Communicate:
1. Urdu (Yes/No) 2. Pushto (Yes/No) 3. English (Yes/No)
Qualification (Professional):
Title Institution Date of Graduation
1 ______________________ _ ___________________________________ ____________________
2 ______________________ _ ____________________________________ ____________________
3 ______________________ _ ____________________________________ ____________________
Working Experience:
Title of job Institution Date / Duration
1 _______________________ _____________________________________ _____________________
2 ________________________ _____________________________________ _____________________
3 ________________________ _____________________________________ _____________________
If selected how long you intend to stay in this hospital:_____________________
Indicate 2 references who if asked can give details about you:
Name Address Phone No
1 ____________________________ ______________________________ _____________________
2 _____________________________ ______________________________ _____________________
Signature:_________________________________ Date:_____________________
Note: Please attach the following which ever applicable
1. Recent Photograph 2. Diploma/Graduation/Post Graduation Certificates 3.Experience Certificate
4. NIC 5. Domicile Certificate