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LIAQUAT COLLEGE OF MEDICINE & DENTISTRY

Admission Form
MBBS

Student Information
Name of Applicant: Address: Telephone Number Mobile No: Email ID: Religion: Nationality: Date of Birth: Age: Marital Status CNIC NO. Father's Name Father's Profession Office Address: Office Phone: Res. Phone: Cell No. Fax No. Email ID: Residential Address:

BDS
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Guardian's Information
Guardian's Name Guardian's Profession Office Address: Office Phone: Res. Phone: Cell No. Fax No. Email ID: Residential Address:

EDUCATIONAL QUALIFICATION:
{Please attach attested photocopies of the supporting documents} Degree/ Diploma Certificate Institution Attended Board/ University Grade/Marks Year Passed

Have you ever been requested to withdraw due to academic reasons from program at any educational institution? Yes If yes, state the date, name and location of institution. No

Declaration:
I agree, if admitted to the Liaquat College of Medicine & Dentistry, to comply with college regulations. I certify that the information on this application is true and complete in all respect and that I have withheld no information. I understand that misrepresentation, falsification of documents, or withholding of requested information regarding this application are serious offences and I am responsible for any of the information mentioned above.

Date of Submission

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Return the completed application to LCMD with the following: 1. Clear and legible photocopies (Four sets) of all educational documents (Including marksheets, certificates and transcripts) 2. Certificates of extra curricular activities, if any 3. 4 Recent passport size photographs attested 2 from front & 2 from back bearing the name . 4. 2 Photocopies of the candidates national identity card, if the candidate has attained the age of eighteen years, B form if he/she is below the age of eighteen years. 5. The Equivalence certificate of such candidates will not be accepted if he/she has not studied and passed the subjects of English, Physics, Chemistry and Biology in his/her 11th and 12th grade or A-level or other equivalent examination recognized by the IBCC, Islamabad. Additional documents for Overseas Candidates (a) Out of three science subjects Biology and Chemistry are essential subjects. The 3rd science subject could be physics or Mathematics. 6. The chairman admission board reserves the rights to scrutinize the educational document of such applicants. In case any discrepancy is found with regard to the eligibility of the calculation of marks of any applicant he will refer the matter back to the IBBC for reconsideration in the light of discrepancy.

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