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    College of Physicians & Surgeons Pakistan: Online Application Form (FCPS-I) Examination

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    Usama Bilal
    This document is an online application form submitted by OZAIR BILAL AHMED for the FCPS-I examination in June 2020 as a repeater candidate. It provides his personal details like name, father's name, address, contact information, as well as details of the last exam he appeared for. It also shows that he has selected Surgery and Allied as his speciality and paid a fee of PKR 25,000 through debit/credit card for appearing in the exam at the Multan examination center.

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    College of Physicians & Surgeons Pakistan: Online Application Form (FCPS-I) Examination

    Uploaded by

    Usama Bilal
    177 views2 pages
    This document is an online application form submitted by OZAIR BILAL AHMED for the FCPS-I examination in June 2020 as a repeater candidate. It provides his personal details like name, father's name, address, contact information, as well as details of the last exam he appeared for. It also shows that he has selected Surgery and Allied as his speciality and paid a fee of PKR 25,000 through debit/credit card for appearing in the exam at the Multan examination center.

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    This document is an online application form submitted by OZAIR BILAL AHMED for the FCPS-I examination in June 2020 as a repeater candidate. It provides his personal details like name, father's name, address, contact information, as well as details of the last exam he appeared for. It also shows that he has selected Surgery and Allied as his speciality and paid a fee of PKR 25,000 through debit/credit card for appearing in the exam at the Multan examination center.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    177 views2 pages

    College of Physicians & Surgeons Pakistan: Online Application Form (FCPS-I) Examination

    Uploaded by

    Usama Bilal
    This document is an online application form submitted by OZAIR BILAL AHMED for the FCPS-I examination in June 2020 as a repeater candidate. It provides his personal details like name, father's name, address, contact information, as well as details of the last exam he appeared for. It also shows that he has selected Surgery and Allied as his speciality and paid a fee of PKR 25,000 through debit/credit card for appearing in the exam at the Multan examination center.

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    © All Rights Reserved
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    College of Physicians & Surgeons Pakistan Repeater

    Form No: 769-220181


    7th Central Street, Defence Housing Authority, Karachi -75500, Pakistan
    Tel: 9207100-09 , Fax: 9207120, 5881444, UAN: 111-606-606
    Website: www.cpsp.edu.pk

    Online Application Form (FCPS-I) Examination

    Term: 15-JUN-2020
    Registration Type: Repeater
    Enrolment No: F-20-00360
    Examination Center: MULTAN
    Selected Speciality: SURGERY AND ALLIED
    Fee Type: Debit/Credit Card Fee Amount PKR 25000
    Fee Submission City Lahore Transaction ID: 210762545775
    Receipt #: LHR-O-20-10503 Receipt Date: 21-05-2020

    Profile Information
    Medical Reg. No: 100536-P
    Medical Reg. issue date: 19-12-2018 Medical Reg. expiry date: 31-12-2022
    Full Name: OZAIR BILAL AHMED
    Father's name: BILAL AHMAD
    Nationality: Pakistan Identity Card No: 31102-2633746-3
    Gender: Male Marital Status: Single
    Date of Birth: 25-12-1993
    Email: ozairbilal@live.com

    Present/Mailing Address (Residential Only)


    Address: HOUSE NUMBER 97, BEHIND FATIMA PLAZA OLD EID GAH ROAD
    Chishtian, Punjab, Pakistan
    Tel (Res.): 0632440077 Tel (Office):
    Cell: 03007877134 Postal Code:

    Permanent Address (Residential Only)


    Same as Mailing Add: Yes
    Address: HOUSE NUMBER 97, BEHIND FATIMA PLAZA OLD EID GAH ROAD
    Chishtian, Punjab, Pakistan
    Tel (Res.): 0632440077 Tel (Office):
    Cell: 03007877134 Postal Code:

    Particulars of Last Examination Appeared


    Roll Number: 61512 Date of Examination:
    Enrolment: F-20-00360 Center:

    Declaration
    do hereby declare that information given above is correct to the best of my knowledge. Incorrect information may lead to cancelation of enrollment /
    admission / results and disciplinary action.

    Signature of Candidate: ________________________________


    Dated: 21-05-2020

    Note:

    Once entered in the application the center and subject will only be changed after submission of prescribed fee for this change.

    page 1 / 2
    ORIGINAL - Concerned Department DUPLICATE - Applicant

    College of Physicians and Surgeons Pakistan College of Physicians and Surgeons Pakistan

    Debit/Credit Card Debit/Credit Card

    Center: Lahore PMDC/En.No: F-20-00360 Center: Lahore PMDC/En.No: F-20-00360


    Receipt #: LHR-O-20-10503 Date: 21-05-2020 Receipt #: LHR-O-20-10503 Date: 21-05-2020
    Name: OZAIR BILAL AHMED Name: OZAIR BILAL AHMED
    Trans ID: 210762545775 Approval Code: 381352 Trans ID: 210762545775 Approval Code: 381352

    Form No: 769-220181 Form No: 769-220181

    Fee Type Session Amount Fee Type Session Amount

    Exam Fee - FCPS-I JUN-2020 PKR 25000 Exam Fee - FCPS-I JUN-2020 PKR 25000

    Bank Service Charges PKR 925 Bank Service Charges PKR 925

    Total: PKR 25925 Total: PKR 25925

    Amount in words: Twenty-Five Thousand Nine Hundred and Twenty-Five Only (PKR) Amount in words: Twenty-Five Thousand Nine Hundred and Twenty-Five Only (PKR)

    Note: Note:
    In case of any refund/charge back against cards transaction through internet payment In case of any refund/charge back against cards transaction through internet payment
    gateway, the candidate should claim the refund/charge back from CPSP directly. gateway, the candidate should claim the refund/charge back from CPSP directly.

    page 2 / 2

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