Interview will be held on 27.07.
2022
CAPITAL DEVELOPMENT AUTHORITY
CAPITAL HOSPITAL ISLAMABAD
Photograph
APPLICATION FORM HOUSE JOB TRAINING
PMDC Registration No_________ (Valid from ___________ to _____________)
PARTICULARS OF CANDIDATE
Name of the candidate_____________________________________________________________________
Father’s / Husband name __________________________________________________________________
Name of College _________________________________________________________________________
Date of birth_______________________ Domicile____________________ Nationality__________________
CNIC No. _______________________________ Mobile No. ______________________________________
Date of passing MBBS ________________ Session From __________________ To _______________
Note: Candidate who has passed final examination during last 12 months upto closing date of submission of
application will be considered as Fresh Candidate.
DETAILS OF PROFESSIONAL EXAMINATIONS OF MBBS
Professional Date of Marks Attempts
Examination Passing Marks Obtained Max. Marks Availed
1 Professional
st
(Part-I)
1st Professional
(Part-II)
2nd Professional
3rd Professional
4th
Professional /
Final year
Either CDA Employees’ son or daughter (Yes) (No)
If yes then please provide documentary evidence
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GENERAL
a. Have you ever been removed or expelled from any Institution? Yes / No
(if yes)
i. Name of the Institution_________________________________________
ii. Year____________ Period of removal/expulsion_____________________
iii. Reason for punishment_________________________________________
b. Any disciplinary action other than removal / expulsion taken against you like fines,
compulsory migration etc. Yes / No
c. Have you ever been convicted? Yes / No
d. Are you suffering from any illness or disability? Yes / No
e. Have you received any house job training? Yes / No
(if yes) Name of Hospital ____________ Specialty____________ from __________ to ___________
I hereby solemnly declare that:
i. I have not completed one year House Job in any other institution/hospital.
ii. Will abide by the statues, Regulations and Rules etc framed by the Capital Hospital, Islamabad from
time to time.
iii. Will maintain good behavior and pay all dues regularly.
iv. Will work diligently and maintain the dignity and prestige of the Capital Hospital, Islamabad both in
and outside the Hospital.
v. Will be a full time and regular trainee of the Capital Hospital and shall not accept any employment
during the training period.
vi. That I will join the house job training for 06 months. If I want to quit the training in between then I shall
submit my resignation one month before of its commencement otherwise I will pay one month’s
stipend in lieu of notice period.
vii. I will follow all the Terms & Conditions provided by the institution/department.
viii. The information given in the Application Form is correct to the best of my knowledge and belief. And if
anything is found incorrect, Capital Hospital Islamabad will have the right to terminate my House Job.
Dated ___________________
Signature_____________________
Full Name ____________________
Present Address________________
_____________________________
_____________________________
Permanent Address ____________
_____________________________
_____________________________
Following Documents are enclosed herewith: -
a. MBBS (all professionals)
b. Matric / F.Sc Certificate
c. Attempts / Academic certificate from the Principal
d. Provisional Valid Registration from PMDC
e. Valid National Identity card
f. Two recent photographs
