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  Registration No. _________________

To be filled by NTS

Primary & Secondary Healthcare Department

Government of the Punjab
(Career Opportunities for the post of Junior Technician
Vaccinator)

Application Form No:  PSHCD-408864

1. Desired Test City: DERA GHAZI KHAN

2. Desired Post: JUNIOR TECHNICIAN(VACCINATOR)

3. District Applied : Dera Ghazi Khan

4. Personal Information
Name : FAHIM SAJJAD

Father's Name : SAJJAD HUSSAIN

C.N.I.C No. : 32102-6965469-1  

Gender : MALE Date of Birth : 07/11/1998

dd/mm/yyyy

Email : FAHIMSAJJAD803@GMAIL.COM Religion : MUSLIM

District of Domicile : DERA GHAZI KHAN Postal City : DERA GHAZI KHAN

Postal Address : INDUS LAW COLLEGE, NEAR PULL PIYARE WALI, TAUNSA ROAD, DGKHAN

Phone No. (Mobile) : 3061166803 Phone No. (Res) : Phone No. (Office) :

    Registered Disability : NO Nature of Disability :

Are you Disable ? NO

Are you govt employee and applying through proper channel ? NO

 5. Academic Information
Note:
1. NTS will not issue Roll No Slips to those who have not given their academic record accordingly.
2. Write exact degree name & major subject mentioned in certificate/ transcript.

Year Total Obtained

Certificate / Degree Name Degree Name Major Subjects University / Board
Passing Marks/CGPA Marks/CGPA

SSC/O-Level BIO, PHY,

MATRIC 2013 1050 751 BISEDGKHAN
(10 Years) CHEM

HSSC/A-Level BIO, PHY,

FSC 2016 1100 499 BISEDGKHAN
(12 Years) CHEM

Bachelor B.A 0 0
(14 Years)

Bachelor/Master 0 0
(16 Years)

MS/M.Phil 0 0
(18 Years)

Year
Diploma/Certificate Degree Name Duration Technical Board/Council Name
Passing

Diploma/Certificate

6. Experience

Designation Name of Organization From To

01/01/1900 01/01/1900

01/01/1900 01/01/1900

01/01/1900 01/01/1900

01/01/1900 01/01/1900

01/01/1900 01/01/1900

 Total Experience: 0 Years 0 Months

Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do hereby solemnly affirm that I have

read and understood the conditions for appearing in the NTS Test and that I have filled the form as per
instructions given above and in the event any information contained herein is found to be untrue, I shall
be liable to disciplinary action which may result in cancellation of my test.

Provide 2 recent photograph, to

be pasted in photograph
column
Date: _________________          Signature of the Candidate: __________________

Please attach following documents (duly attested):

(I)CNIC (ii) Two recent passport size photographs (iii) Educational Documents
By hand submission of application form is not allowed.
Mobile phones are not allowed in Test Center premises.
 Help line: Send Application Forms:
+92-51-844-444-1 (Primary & Secondary GOP Project)
NTS Headquarter,
Website. www.nts.org.pk 96, Street No.4, Sector H-8/1, Islamabad
Deposit Id :  PSHCD-408864_                        Deposit Date : ____________________ Deposit Id :  PSHCD-408864_                        Deposit Date : ____________________

Branch Name : __________________________________________     Bank Code : _________________ Branch Name : __________________________________________     Bank Code : _________________

* Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit * Note for Bank Staff:
Please enter Deposit Id for reconciliation at NTS end.
Slip (NTS Copy) along Application Form to NTS Office. Application Form will not be
entertained without Original Deposit Slip (NTS Copy)

Project ID:      203/PSHDP/2021/08 Project ID:      203/PSHDP/2021/08

Applicant's Applicant's
Name :       FAHIM SAJJAD Name :       FAHIM SAJJAD
Father's Father's
Name :       SAJJAD HUSSAIN Name :       SAJJAD HUSSAIN
CNIC No. / CNIC No. /
B. Form No. :       32102-6965469-1 B. Form No. :       32102-6965469-1

Post :       JUNIOR TECHNICIAN(VACCINATOR) Post :       JUNIOR TECHNICIAN(VACCINATOR)

Test Fee: Rs. 180 + 35(16% GST) = 215 Test Fee: Rs. 180 + 35(16% GST) = 215

Amount 215/- Amount in

Two Hundred & Fifteen Rupees Only Amount 215/- Amount in
Two Hundred & Fifteen Rupees Only
Rs: Words: Rs. Rs: Words: Rs.
Non Refundable / Non Transferable Non Refundable / Non Transferable

____________     ____________     ____________ ____________     ____________     ____________
    Applicant Signature                    Cashier                         Officer     Applicant Signature                    Cashier                         Officer

Deposit Id :  PSHCD-408864_                                                                                                                                                                                                                           Deposit Date : ____________________

Branch Name : __________________________________________                                                                                                                                                                             Bank Code : ___________________

* Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip (NTS Copy) along Application Form to NTS Office. Application Form will not be
entertained without Original Deposit Slip (NTS Copy)

Project ID:      203/PSHDP/2021/08
Applicant's
Name :       FAHIM SAJJAD
Father's
Name :       SAJJAD HUSSAIN
CNIC No. /
B. Form No. :       32102-6965469-1

Post :       JUNIOR TECHNICIAN(VACCINATOR)

Test Fee: Rs. 180 + 35(16% GST) = 215

Amount 215/- Amount in

Two Hundred & Fifteen Rupees Only
Rs: Words: Rs.
Non Refundable / Non Transferable

____________     ____________     ____________
    Applicant Signature                    Cashier                         Officer