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Personal Information Form

Saniya Zehra provides her personal information in this form for Tehran University of Medical Sciences. She lists her name, passport information, addresses, contact details for emergency purposes, and demographic and educational information. Saniya is an Indian national studying for her undergraduate M.B.B.S. degree in the School of Medicine at TUMS and acknowledges the minimum English proficiency requirement.

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78 views1 page

Personal Information Form

Saniya Zehra provides her personal information in this form for Tehran University of Medical Sciences. She lists her name, passport information, addresses, contact details for emergency purposes, and demographic and educational information. Saniya is an Indian national studying for her undergraduate M.B.B.S. degree in the School of Medicine at TUMS and acknowledges the minimum English proficiency requirement.

Uploaded by

ah95550154
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Personal Information Form

Tehran University of Medical Sciences


Office of Vice-Chancellor for Global Strategies and International Affairs Division of International Student Admissions

SECTION 1. PERSONAL INFORMATION


Full Name as appears on your passport S A N I Y E Z E H R A
First Name: ______________________________________

Middle Name: ____________________________________

Z A I D I
Last Name: ______________________________________

Passport Number: _________________________________


W 5 6 9 0 9 1 8

Nationality (Country that issued your passport): Indian


___________________________
Other Nationalities (if applicable): _______________________________________

Residence Address in Iran: Alley-9, Street-73, Bolv. Musa Sadr , Qom,Iran


___________________________________________________________________
House no.540 Gali no. 80,Sanjay colony Sec-22 Faridabad
Residence Address in your Country: ____________________________________________________________
Home Phone: +91 999322439
___________________________________ +91 9599672540
Cell Phone: ______________________________

Email Address: ______________________________________________________________________________


S A N Y A Z E H R A 7 3 8 @ G M A I L . C O M
SECTION 2. CONTACT INFORMATION (in case of emergency)

Name: JAMAL HAIDER ZAIDI


__________________________________
Relationship: Brother
_____________________________
Postal Address: Alley-9,street-73,Bolv. Musa Sadr ,Qom ,Iran
______________________________________________________________________________
City and Country: Qom ,Iran
____________________________ Qom
State/Province: ______________________________
Zip Code: 3719634915
__________________________________
Cell Phone Number: __________________________ +98 9309525556
Phone Number: ______________________________

SECTION 3. DEMOGRAPHIC INFORMATION


07
Date Of Birth: Day_______ 10
Month_______ 2004 Marital Status:
Year_______ Married  Single 
Gender: Male  Female  Hindi
Official language of your country: __________________
Country of Birth: India
________________________________ Urdu
Mother Tongue: _________________________________
SECTION 4. EDUCATIONAL INFORMATION at TUMS-IC (Specifications of your admission)
Name of your School: School of medicine
_____________________________ Undergraduate
Level of Studies: _______________________________
Name of your Department: M.B.B.S
____________________________________________
Name of Supervisor (if applicable): ______________________________________

SECTION 5. SIGNATURE
I acknowledge that I know a minimum IELTS score of 5.5 (or equivalent TOEFL score) is required.
I hereby acknowledge that the information provided in this form is correct.

Full Name Signature Date

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