Postgraduate certificate course in Family Medicine - Batch (2024 - 2025) - Application Form
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Email *
Full Name *
Father’s/Husband’s Name: *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
CNIC Number *
Email (in use)
 *
Mobile Number/ WhatsApp *
Mailing/Home Address *
Current place of Residence (City & Country)
 *
Year of Graduation from Medical College
 *
Current working place/hospital/clinic     *
Current Designation
 *
List your academic qualifications (starting from most recent) Degree/Diploma/Fellowship/Membership
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2.
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4.
Computer Skills
MS WORD (COMPUTER PROFICIENCY) *
MS POWERPOINT (COMPUTER PROFICIENCY) *
INTERNET (COMPUTER PROFICIENCY) *
ONLINE LEARNING SOFTWARE [(E.G ZOOM), (COMPUTER PROFICIENCY)] *
STATEMENT OF PURPOSE
(Please write down the purpose for enrolling in this course and the expected outcome that you would like to achieve at the end of this course.) Maximum 250-300 words
*
Instruction: (Please send following documents on this mention (Your Name) - PGCertFM24 as Subject familymedicine@lnh.edu.pk or 0346-0101614
(Scan Copies of the Required Documents)
MBBS Degree
Valid PMDC/PMC Registration
Valid CNIC
LNH employment card/medical college ID card (for LNHMC employees and students only)
Payment Mode
(Please send scan copy of slip or provide hard copy at Department of Family Medicine, Wajid Ali Shah basement)
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Where did you heard about this course
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Thank you
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