PAKISTAN MEDICAL COMMISSION

Website: pmc.pakistan.gov.pk
Email: info@pmc.pakistan.gov.pk Attach two recent
photographs here.
APPLICATION FOR PROVISIONAL LICENSE
(for one year house job only)
 Tick the relevant Box
FOREIGN DEGREE MEDICAL
PAKISTANI DEGREE DENTAL
YEAR OF GRADUATION MALE
Y Y Y Y FEMALE
PMC STUDENT REGISTRATION (if any)
NAME OF COLLEGE:
DEGREE AWARDING UNIVERSITY:
NATIONALITY:
CNIC:
PASSPORT NO: (FOREIGN NATIONAL)
NAME:
FATHER NAME:
DATE OF BIRTH: D D M M Y Y Y Y
Y Y Y Y
POSTAL ADDRESS:

CITY: DISTRICT:
PROVINCE: COUNTRY:
EMAIL: MOBILE:

Check List
1. Provisional Certificate or Degree of College/ University
2. NEB Step III result (for Foreign graduates)
3. Two Color photographs (passport size)
4. For extension of provisional license, apply on the same form along with original/copy of
previous (provisional) certificate
5. A bank draft/pay order/Bank deposit slip of Rs_____________No._____________
Dated______________
Name of issuing bank & branch__________________________________________

APPLICANTS SIGNATURE: _____________________

 Fee
Fee for Provisional License Rs. 1,000/-
Courier Fee outside Pakistan Rs. 3,000/-

FOR OFFICE USE ONLY

Received Rs. Receipt No. Date:

PMC REGISTRATION NO: - - M/D

Registration Date: Valid Upto: _____

Verification Officer: ______

Member Licensing: