ABDUL GHANI INSTITUTE OF MEDICAL SCIENCES

Center Plate, Muzaffarabad, Azad Jammu & Kashmir

Ph: 05822-920020, 920021 | Email: agimsmzd@gmail.com

PASTE PHOTO

AFFIX STUDENT PHOTO

ADMISSION FORM

I. PERSONAL INFORMATION

1. Name of Student (As per CNIC/B-Form)*

2. Father's / Guardian's Name*

3. CNIC / B-Form Number*

4. Date of Birth*

5. Gender*

6. Religion

7. Domicile (District/State)*

8. Nationality

9. Mobile Number*

10. Landline / PTCL

11. Email Address

12. Permanent Residential Address*

II. PROGRAM SELECTION

Select Program Category*

BS PROGRAMS

(4 Years)

FSC MEDICAL

(2 Years)

DIPLOMA

(4 Semesters)

PHARMACY B

(2 Years)

DPT

(5 Years)

Select Course*

Medical Lab Technology

Emergency Medicine Technology

Cardiology

Anesthesia

Operation Theater Technology

Radiology Technology

Select Course*

Medical Lab Technology

Dispenser

Dental Technology

Cardiology

Operation Theater

Radiology

Physiotherapy

Ophthalmic

Dialysis

Select Course*

Dispenser

Operation Theater

Pathology MLT

Radiology

Dialysis Technician

Dental Hygienist

Course (Auto-Selected)

Pharmacy Technician B Category

Course (Auto-Selected)

Doctor of Physical Therapy (DPT)

III. ACADEMIC QUALIFICATION

Examination	Year	Roll No.	Registration	Marks Obtained	Total Marks	Percentage	Discipline	Board/University
Matriculation
Intermediate

Declaration

I solemnly declare that all the above stated information is correct to the best of my knowledge and belief. I understand that any false information or concealment of facts may result in the cancellation of my admission at any stage. I agree to abide by all rules and regulations of the Abdul Ghani Institute of Medical Sciences.

Applicant's Signature

Father/Guardian's Signature

Principal's Signature