PPSC Application Form

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PPSC-4

PUNJAB PUBLIC SERVICE COMMISSION


51500129
Application Number:

1.Post Applied For: CONSULTANT ORTHOPAEDIC SURGEON


2.Department: PRIMARY AND SECONDARY HEALTHCARE DEPARTMENT
3.Advertisement Number: 27/2022
4.Case Number: 44E2022
5.Fee Deposit Date: 17-11-2022
6.Amount: Rs. 600/-
7.Bank Name/PSID No: MEEZAN BANK LTD. /
40382211166970700
8.Candidate's Name: RIZWAN ARSHAD
9.Father's Name: MUHAMMAD ARSHAD
10.Postal Address: HOUSE 731 WATER SUPPLY ROAD SARGODHA
11.Gender: MALE 12.Religion MUSLIM
13.CNIC NO: 3840365672745 13(a).CNIC Expiry 19-01-2032
Date:
14.Marital Status: MARRIED 14(a). Spouse Name: SANA REHMAN
15.DOB: 03-04-1985 16.Age (On Closing Age: 37 year(s), 7 Month(s), 15
Date): Day(s)
17.Phone No: 3226031253 18.Mobile Number: 03226031253
19.E-mail: yours_pacemaker@yahoo.com
20.Domicile: SARGODHA 20(a).Domicile Issue 28-08-2004
Date:
21.Special Person? NO
(a).Type of Disability: NA (b).Examination Mode: NA
(c).Disability Certificate Ref. No. NA (d).Disability Certificate Issue NA
Date:
22.Government Employee? YES
(a).Type of Service Punjab (Contractual) (b).PPSC Employee NO
(c).Date of Joining 04-04-2015 (d).Length of Service 7 Year(s) 7 Month (s)
4 Day (s)
(e).Obtained NOC From Employer? YES
23.Retired / Released Armed Forces NO
Person?
(a).Length of Service NA (b). Convicted by Court Martial? NO
24.Near relative working in PPSC? NO
(a).Name of Relative NA (b). Designation/Relation NA
25.Ever Dismissed / Removed / 25(a).Dismissed / Removed /
Discharged from Government / Discharged ?
Autonomous body ? NO NA

(c).If yes, produce Notification /


(b).Reason of Removal / Dismissal NA Detail of Charges from
/ Discharge concerned Department at the
time of interview, if called for
26.Do you Claim Additional Marks
as an Unemployed Child of a
Punjab Unemployed Child
of a NO 26(a).Father / Mother CNIC No: NA
Punjab Government Servant who
was Incapacitated or Died while
in Service?
27.Ever been Convicted by a Court in NO 27(a).If Yes, Produce Detail at the
Pakistan? Time of Interview, if Called for
28.Are you Facing any Criminal Trial 28(a).If Yes, Produce Detail at the
in any Court of Pakistan? NO Time of Interview, if Called
for
29.PMDC / PNC / OEC / PCATP / PBC 63444-P 29(a).Registration Expiry Date: 11-01-2024
NO :
30.Medical Certificate Issue Date: NA
31.Written Test / Examination / SARGODHA 32.No. of Chances Availed for this 0
Interview Centre: Post:
33.Physical Standard (For Uniform
Posts Only):
(a).Height NA
(b).Chest Normal NA (c).Chest Expanded NA
(d).Distant Vision Left NA (e).Distant Vision Right NA
(f).Near Vision Left NA (g).Near Vision Right NA
34.Academic Qualifications:
RESULT
CERTIFICATE/DEGREE BOARD / UNIVERSITY SUBJECTS DECLARED EXAMINATION SYSTEM
OBTAINED TOTAL %AGE /
MARKS MARKS GRADE
ON
MATRICULATION B.I.S.E SARGODHA 15-06-2002 ANNUAL 637 850 74.94
INTERMEDIATE B.I.S.E SARGODHA 06-08-2004 ANNUAL 722 1100 65.64
MBBS XINJIANG MEDICAL 01-07-2011 SEMESTER 327 400 81.75
UNIVERSITY CHINA
FCPS (ORTHO. COLLEGE OF PHYSICIAN & 25-10-2022 - - -
SURGERY) SURGEONS OF PAK.
35.Service Record (if required)
POST HELD DEPARTMENT / OFFICE STARTING DATE ENDING DATE SCALE
Registrar Teaching Surgical Unit 05-07-2013 03-04-2015 0
Medical Officer District Orthopedic Unit 04-04-2015 17-11-2022 17
36.Vaccination Status : Fully Vaccinated 36(a).Certificate VC6398830293
Number:
36(b).Reason for
Exemption from NA
Vaccination:
DISCLAIMER: I certify that all information in the
Application Form submitted by me is correct and in case any information is
found
to be incorrect, it will disqualify my candidature. I also certify that I have read
all requirements / conditions of this post
along with the General Instructions in
this regard.
Date: 17-11-2022 Candidate's Signature: ---------------------------------------
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