APPLICATION FORM                                                                             TAG # (For
Office Of The District Health Officer, Health Department Islamabad                                                         Official use)
                                                                            Applying for: Assistant (BPS-15)
(263)
Bank Online Deposit (*Note: Application Form will not be entertained without Original Deposit Slip.)
           ALFALAH,                             HBL,                              ABL,
 ☐      (ANY BRANCH)
                                ☐        (ANY BRANCH)
                                                                 ☐        (ANY BRANCH)
                                                                                                    _______________
                                                                                                      Branch Code
                                                                                                                             _______________
                                                                                                                               Deposit Date
       Note: Test Center in the desired city will be arranged for minimum of 200 applicants. Once selected a test center cannot be changed.               Passport size Recent
                       ☐ Islamabad                     ☐ Lahore                 ☐ Multan                             ☐ Karachi                           Photograph Affix with
 Test City:            ☐ Quetta                        ☐ Peshawar               ☐ D.I. Khan                          ☐ Hyderabad                           Gum (Latest By 6
 (Tick only one)       ☐ Sahiwal                       ☐ Abbottabad             ☐ Gujranwala                         ☐ Muzaffarabad                            months)
                       ☐ Gilgit                        ☐ Sargodha               ☐ Sukkur                             ☐ Abbottabad
                                                                          Note: ALL DATA FIELDS ARE REQUIRED. FILL YOUR
 Domicile District: -----------------------------------                   APPLICATION FORM CAREFULLY.
 Domicile              ☐      Punjab             ☐      Balochistan            ☐        Sindh (U)           ☐        Sindh (R)
 Province:             ☐      KPK                ☐      Islamabad Capital Territory                         ☐        FATA
 (Tick only one)       ☐      Azad Jammu and Kashmir                                ☐      Gilgit Baltistan          ☐       Other
 1. Personal Information (In Block Letters)
 Name (in Full):           __________________________________________________                                                   Note: Tick Only One Circle in each Row.
 Father’s Name:                                                                                                                   Religion:      ⃝ Muslim         ⃝ Non-Muslim
                           __________________________________________________
 CNIC/B-Form:                                                                                                                     Are You Disable?                      ⃝ Yes      ⃝ No
                                                                                                                                  Gender:                   ⃝ Male          ⃝ Female
 Age: __________              Date of Birth (D-M-Y) ___ -____- _____                     Marital Status:________                  Armed Forces:                         ⃝ Yes      ⃝ No
                           __________________________________________________                                                       Only for personnel of Armed Forces of Pakistan
 Postal Address:                                                                                                                  Deceased Servant: ⃝ Yes ⃝ No
                           __________________________________________________                                                     Deceased Civil Servant wife, son or daughter
                                                                                                                                  Government Servant:           ⃝ Yes ⃝ No
 Phone #: ______________ Cell #: ________________                                          (Do not give here Network
                                                                                           converted mobile Numbers)              Scheduled Cast /Buddhist:             ⃝ Yes      ⃝ No
 2. Academic Information (Note: In case of incomplete academic information, Your Application will be Declined.)
   Certificate/Degree                       Degree Title                 Major Subjects                   Year of         Marks               Total        Grade/           Institution
                                                                                                          Passing        Obtained             Marks      Percentage           Name
 SSC (10 years)
 HSSC / DAE / A-Level
 (12 / 13 years)
 Bachelor (14 years)
 Bachelor(Hons)/Master
 (16 years)
 MS / M.Phil. (18 years)
 PhD
 Other (Diploma / Certificate)
 3. Employment Information (If Applicable ) (Note: If you need more rows to write your information, you can add an additional page with Application
      Form.)
     Organization Type                           Organization Name                               Designation                 Job Description          Start Date            End Date
 (Government / Semi Government             (Name of the Organization / Dept.)            (Your Designation / Position                                 (Starting Date)           (End Date)
           / Private)                                                                               Title)
4. Undertaking by Applicant
    I                                              d/s/w of                                          do hereby solemnly
    affirm that I have read and understood the conditions for applying in the above mentioned Post 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 candidature at any stage.
       Signature & Date: ……………………………….……….                         Thumb Impression (Left Hand): ………………………………………
Document Check list:
Tick if Attached / selected:
 ☐ Photograph is Attached
 ☐ Original bank Deposit Slip is Attached on the back side of Application Form
 ☐ CNIC Copy is Attached on the back side of Application Form
Instructions:
       •   ALL DATA FIELDS ARE REQUIRED TO BE FILLED. FILL YOUR APPLICATION FORM CAREFULLY.
       •   Application Fee (Service Charges) is nonrefundable / nontransferable. Bank Online Deposit of Rs. 100/- must be
           attached with application form.
       •   In case of more than one apply use separate application form along with original deposit slip.
       •   In case of more than one apply use separate envelope.
       •   Application must reach OTS office latest by last date of submission of application form.
       •   OTS will not be responsible for l ate receiving of application through courier / Pakistan post etc.
       •   Attach your recent photograph (Latest by 6 Months), CNIC copy, original bank deposit slip with this application form.
       •   Without Signature & Thumb impression, your application form will not be entertained.
       •   Without photograph your application form will not be entertained.
       •   In-complete forms will not be entertained. (All the fields are mandatory / Required)
       •   In Person/By hand sub mission of Application form is n o t allowed.
       •   Mobile phones or other electronic gadgets are n o t all owed in test center premises.
       Cut Address box given below and affix it with gum on the envelope.
                                                           Send Registration Form to:
                                                                       k
                                                            Manager Operations,
                                                       Open Testing Service (OTS),
                                                      Office No 01, Central Avenue,
                                                    Phase 6, Bahria Town, Islamabad
                       Help Line: 051-111 687 222 Email: info@ots.org.pk, Website: www.ots.org.pk