APPLICATION FORM FOR OBTAINING A CERTIFICATE FROM

MINISTRY OF HEALTH, ISLAMABAD FOR DOCTORS DESIRING TO

GO ABROAD FOR POST GRADUATION STUDIES/TRAINING

Name of the Applicant : ________________________________

Father’s Name : ________________________________
Domicile : _________________
Date of Birth : ________________
Education / Qualification : __________________________
National Identity Card No. : ____________________
Correct Email Address (Valid) :
Where and when the house job was done and in : _________________________________
which subject

Marital status : _____________

Name of College from which the Degree of MBBS : ___________________________________
was received and there Year (Copy) PMDC
Certificate (Copy)

Description of posts held after completion of : __________________

House Job

Presently Serving in : ____________________________________

Are you government serving in : ___________________

Description of Required Training Abroad : ____________________________________

Whether Training Facilities are available in : _____________________

Pakistan in the required field
Whether admission received from the Institution : _____________________________________
Abroad (Copy)
The Name of Educational Institution Abroad : _____________________________________
where the applicant wishes to study
Duration of Postgraduate Course with the date of : ______________________________
its commencement
Undertaken that after the training abroad shall : _________________________________
return to Pakistan and serve (Affidavit)

Date : ____________________

Required documents :
1. Application Form
2. Letter of Contract (Original) Signature : ______________________
3. Fresh Affidavit (Notarized Original))
4. Copy of PMDC Certificate (Valid) Full Address in Pakistan : _______________
5. Copy of Degree of MBBS ____________________________________
6. Copy of NIC
Contact No: ________________________
7. Copy of Passport (Valid)
(All copies should be Attested)
 AFFIDAVIT
(On Stamp Paper of Rs. 5/- and above in Pakistan)

I______________________ S/o / D/o ____________________ do

hereby solemnly affirm and declare as under:

1. That I am a citizen of Pakistan by Birth.

2. That after completion postgraduate studies/residency
programme in the Specialty ___________________ will
return to Pakistan to serve my country and nation.

3. That I am not a Government employee.

That the contents of this affidavit are true and correct to the best of

my knowledge and belief and nothing has been concealed or

withheld.

Deponent

Dr. ________________________

CNIC No. ____________________

(To be Notarized here)