Bank Copy PMDC Copy Applic ants's Copy

Pakistan Medical & Dental Pakistan Medical & Dental Pakistan Medical & Dental
Council Council Council
G-10/4 Mauve Area, Islamabad G-10/4 Mauve Area, Islamabad G-10/4 Mauve Area, Islamabad

MCB TBD Collec tion A/C: 1226540861000010 MCB TBD Collec tion A/C: 1226540861000010 MCB TBD Collec tion A/C: 1226540861000010
TBD Customer Code: PMC02 TBD Customer Code: PMC02 TBD Customer Code: PMC02
Challan #: 2220969976 Due Date: 22-12-2023 Challan #: 2220969976 Due Date: 22-12-2023 Challan #: 2220969976 Due Date: 22-12-2023

Applic ant Name:
Applic ant's CNIC:
Applic ant's Reg. Number:
Depositor's Name:
Depositor's CNIC:
Depositor's Contac t#:
Deposit Date:
Payment Mode:
SYED ALI AKBAR SHAH Applic ant Name:
3740563457233 Applic ant's CNIC:
64421-P Applic ant's Reg. Number:
Depositor's Name:
Depositor's CNIC:
Depositor's Contac t#:
Deposit Date:
Payment Mode:
SYED ALI AKBAR SHAH Applic ant Name: SYED ALI AKBAR SHAH
3740563457233 Applic ant's CNIC: 3740563457233
64421-P Applic ant's Reg. Number: 64421-P
Depositor's Name:
Depositor's CNIC:
Depositor's Contac t#:
Deposit Date:
Payment Mode:

Sr.# Fee Description Amount Sr.# Fee Description Amount Sr.# Fee Description Amount
1 Any Change in Data / Lic ense 2000/- 1 Any Change in Data / Lic ense 2000/- 1 Any Change in Data / Lic ense 2000/-
2 Bank Charges 30/- 2 Bank Charges 30/- 2 Bank Charges 30/-
3 Courier Fee (Foreign) 7000/- 3 Courier Fee (Foreign) 7000/- 3 Courier Fee (Foreign) 7000/-
Total: Nine Thousand Thirty Only 9030/- Total: Nine Thousand Thirty Only 9030/- Total: Nine Thousand Thirty Only 9030/-

Instructions: Instructions: Instructions:

1. The applic ant must fill in c omplete partic ulars and 1. The applic ant must fill in c omplete partic ulars and 1. The applic ant must fill in c omplete partic ulars and
no field be left blank. no field be left blank. no field be left blank.
2. The fee is payable at any branc h of MCB Bank. 2. The fee is payable at any branc h of MCB Bank. 2. The fee is payable at any branc h of MCB Bank.
3. The fee shall not be ac c epted after due date. 3. The fee shall not be ac c epted after due date. 3. The fee shall not be ac c epted after due date.

Depositor's Signature Cashier's Signature Depositor's Signature Cashier's Signature Depositor's Signature Cashier's Signature

Issuanc e Date: 22-11-2023 Issuanc e Date: 22-11-2023 Issuanc e Date: 22-11-2023