College of Physicians & Surgeons Pakistan: Elective Rotation Form (FCPS-II Training)
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afh fsdCollege of Physicians & Surgeons Pakistan: Elective Rotation Form (FCPS-II Training)
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afh fsdCollege of Physicians & Surgeons Pakistan Form No: 2024-95774
7th Central Street, Defence Housing Authority Phase-II, Karachi -75500, Pakistan
Tel: 99207100-09 , Fax: 99207120, 35881444, UAN: 111-606-606 Application Date: 03-09-2024
Website: www.cpsp.edu.pk
Elective Rotation Form (FCPS-II Training)
Full Name: GUL MUHAMMAD
Father's Name: MUHAMMAD HUSSAIN
Nationality: Pakistan
NIC No: 33102-2161851-9
Date of Birth: 10-09-1993
Gender/Marital Status: Male / Single
CPSPID: 2021-5579 RTMC No: MED-2021-277-18473
Registration Information
Speciality: MEDICINE
Country/State/City: Pakistan, Punjab, Faisalabad
Institute: AZIZ FATIMAH HOSPITAL/ AZIZ FATIMA MEDICAL & DENTAL COLLEGE
Supervisor: GHULAM ABBAS
Training Joining: 01-07-2021
Mailing Address (Residential Only)
Address: HOUSE #300 C BLOCK GHULAM MUHAMMAD ABAD
Country/State/City: Faisalabad, Punjab, Pakistan
Tel (Res.): Tel (Office):
Cell: 03215308250 Postal Code:
Rotational Information
Rotational Speciality: NEPHROLOGY
Country/State/City: Pakistan, Punjab, Faisalabad
Rotational Institute: AZIZ FATIMAH HOSPITAL/ AZIZ FATIMA MEDICAL & DENTAL COLLEGE
Rotational Supervisor: GHULAM ABBAS
Date From: 01-09-2024 Date To: 31-10-2024
Note:
It is mandatory that application must be submitted in the first week of commencement of rotational training.
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College of Physicians & Surgeons Pakistan Form No: 2024-95774
7th Central Street, Defence Housing Authority Phase-II, Karachi -75500, Pakistan
Tel: 99207100-09 , Fax: 99207120, 35881444, UAN: 111-606-606 Application Date: 03-09-2024
Website: www.cpsp.edu.pk
Supervisor's Consent
Name of Candidate: GUL MUHAMMAD
Institute: AZIZ FATIMAH HOSPITAL/ AZIZ FATIMA MEDICAL & DENTAL COLLEGE
Signature & stamp of Main (parent) Supervisor: ___________________________________________________
Signature & stamp of Rotational Supervisor: ______________________________________________________
Note:
If you have done rotation at other than parent institute, Please get sign & stamp of Head of Institute (Not HOD).
Signature & stamp of Head of Parent Institute: ____________________________________________________
Signature & stamp of Head of Rotational Institute (Not HOD): ________________________________________
Signature of Candidate: ________________________________ Dated: 03-09-2024
Original Documents to be upload in step-2:
Step1 complete application form duly signed by main & rotational Supervisor, and yourself as an applicant.
Evidence of joining elective rotation duly endorsed by the supervisor.
Appointment / placement order issued by institution"s administration department.
If there is any change in particulars please attach your written application.
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