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PROFORMA FOR HOUSE JOB BDS
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Name *

First Name Last Name
Father's Name *

First Name Last Name
PMC Regn No *
Date of Birth *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Permanent Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell No (Personal) *
Please enter a valid phone number.
Tel No (Res)
Please enter a valid phone number.
Accommodation *
Graduated from (College/University *
Graduated Year *
Final Professional BDS: Marks Obtd/out of *
Final Professional BDS Attempts *
Third Professional BDS: Marks Obtd/out of *
Third Professional BDS Attempts *
Second Professional BDS: Marks Obtd/out of *
Second Professional BDS Attempts *
First Professional BDS: Marks Obtd/out of *
First Professional BDS Attempts *
House Job (Preference)
First: *
Second: *
Third: *
Fourth: *
Please attach the following documents
Provisional Certificate *

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Academic Certificate *

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PMC Registration Certificate *

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Copy of National Identity Card *

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+92(0)992-391443, 390337, 390090
+92(0)992-390221, 391502
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