Roll No_
Attested
Photograph to
be pasted here
by the applicant
THE REGISTRAR
PUNJAB PHARMACY COUNCIL
LAHORE
Sir,
I request for the permission to appear in the examination of the Punjab pharmacy council as provided
under section 29 of the pharmacy act 1976.i submit below the necessary particulars:1. Full Name:
2. Fathers Name:
3. Date of Birth:
4. Religion:
5. Caste:
Phone No:
Dated:
Appear in
Under Roll No.
Dated the
FOR OFFICE USE ONLY
Admission from has been received. Enrollment certificate, Apprenticeship or Dispenser
certificate and other required documents have been checked admission
Fee has also been received. May be admitted please.
Prepare by (Exam. Clerk)
checked by (Assistant)
Cash Receipt No.
Accountant
The Examination Fee is RS.4000/-and if not paid on due date, after the expiry of due date double fee
amounting Rs.8000/-has to be remitted.
Four attested passport size photograph, photocopies of National identity Card, Enrollment certificate,
Metric, Dispenser, (if any), character and Apprenticeship certificate shall have to be attached.
(II) Incomplete form shall not be accepted.
TO BE FILLED BY CANDIDATE
Roll No.
Name:
Name:
Fathers Name:
Fathers Name:
Address:
Address:
Name:
Name:
Fathers Name:
Fathers Name:
Address:
Address:
REGISTERED
ROLL No.
Candidate will be admitted in the Examination Hall production and delivery of this Roll Number slip.
Please bring your National identity card during theory and practical Examination.
at the
Attested
Photograph to be
pasted here by the
applicant
Signature of candidate
REGISTRAR
PUNJAB PHARMACY COUNCIL
3
Following documents must be submitted/attached with the application form:
1. Apprenticeship certificate as required under Pharmacy Act 1967, issued by a Pharmacist
regular employ of Government and notified by the Government of Punjab. (Not for
dispenser). Dispenser shall submit 4 attested photocopies of Dispenser Certificates.
2. Attested ID Card/Domicile.
3. Attested Photocopy of Matric Certificate.
4 Nos.
6 Nos.
Note: -
The above mentioned documents are not needed for supplementary exam,
only pay admission fee Rs.4000/-
APPRENTICESHIP CERTIFICATE
Under Pharmacy Act, 1967
for a period of
Sr. No.
Date:
Signatures
Name
Address
Reg. Cert. No.
Renewal Valid Upto