College of Physicians & Surgeons Pakistan

Regional Centre, G-8/3, Ravi Road, Islamabad

Tel: +92 51 9262590-1, 9261196, website: www.cpsp.edu.pk
8th BASIC Medical Sciences Course
For FCPS Part-I Examinations
(For All Specialties/Disciplines)
From June 15 – July 27, 2011
Venue Course Fee
CPSP, Regional Centre The Course fee Rs 5,000/- is to be deposited
Islamabad on challan form at United Bank Limited G-8
Markaz, Islamabad or Bank draft/Pay Order in
Favour of CPSP-Karachi
Course Coordinators:-
Mr. Habib Ahmad Ch.
Deputy Manager
CPSP Regional Centre
Islamabad
051-9262590-1, 9261196
hachaudhary@cpsp.edu.pk

Organizing Committee:-
Prof. Rizwana Chaudhri
Councilor & Regional Director
Prof. Muhammad Shoaib Shafi
Councilor & Controller of Examinations
Dr. Saadat Ali Khan
Chief Manager, Regional Centre

Note: - Seats are limited and will be provided to those who apply first.
 8th BASIC MEDICAL SCIENCES COURSE
All Disciplines/Specialties
(For FCPS Part l Examinations)
Reg. No__________

REGISTRATION FORM
Dr. ____________________________________________________ _
F/H Name: Marital Status:
NIC: Date of Birth: Photo

E-mail PMDC Reg:

Postal Address:

Specialty:
Mobile: Tel. (Res):
Institute: Tel (Off):

Have you attended such courses before? Yes/No, If yes please mention the

Name of course Institutions Year

Which Exam are you appearing FCPS ___________________________________________

Please give receipt # of course fee _______________ Fee date _____________________

Date: Signature: _____________________

Note: Enclose the following Documents:

Receipt of Course Fee (The Course fee Rs 5,000/- is to be deposited on challan form at United Bank Limited G-8 Markaz,
Islamabad or Bank draft/Pay Order in Favour of CPSP-Karachi).
1 color Photograph

CPSP, Regional Centre, (PIMS) G-8/3 Ravi Road, Islamabad +92 51 9262590-1, 9262590 UAN 111-606-606 website www.cpsp.edu.pk