HUMAN RESOURCES DEPARTMENT RECRUITMENT CELL
JOB APPLICATION FORM
LADY READING HOSPITAL MEDICAL TEACHING INSTITUTE
Recent
P
Photograph
ID Card Copy
Full Name (Mr./Ms./Mrs)
Father/Husband Name:
Present Address: ________________________________________________________________
______________________________________________________________________________
Permanent Address: _____________________________________________________________
______________________________________________________________________________
Telephone # (Residence) Mobile #
Email Address: _________________________________ Date of Birth:
PMC/PNC/PEC NO. (If applicable) ____________ PMC/PNC/PEC Expiry Date: __________________
Medical Faculty/Pharmacy Council Registration No. ______________________________________
Medical Faculty/Pharmacy Council Registration Expiry Date: _______________________________
Domicile: ______________ CNIC #: ___________________ CNIC Expiry Date: _________________
Nationality: ___________ Religion: __________ Place of Birth: ____________ Blood Group: _____
Blood Donation Volunteer: Yes No Marital Status: Single Married Widow
Next of Kin (Name & Address): _____________________________________________________
_____________________ Relationship: _____________ Telephone # -
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HUMAN RESOURCES DEPARTMENT RECRUITMENT CELL
JOB APPLICATION FORM
LADY READING HOSPITAL MEDICAL TEACHING INSTITUTE
Academic Education:
Qualification Name of Institution Year of Passing Division/ CGPA Major Subject
Employment Record (in chronological order, starting with the latest first)
Dates Organization’s Name & Position /Designation Total tenure Reason For Leaving
From To Address The Organization
• Have you ever worked in LRH-MTI before, if YES, how did you leave?
Terminated 24-Hours Resign 1-Month Resign
Other reason:
____________________________________________________________________________________
• Are you under any service bond with your present employer?
Yes No
If yes, give details of the bond:
________________________________________________________Yes_______________No_________
• Were you ever dismissed or asked to leave your job?
• Can we approach your present org.? (If any) Yes No
• Have any criminal charges been brought against you? Yes No
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HUMAN RESOURCES DEPARTMENT RECRUITMENT CELL
JOB APPLICATION FORM
LADY READING HOSPITAL MEDICAL TEACHING INSTITUTE
If yes, please give the details:
____________________________________________________________________________________
Please give at least two references (Educational or Professional) in the space provided below:
Name Designation & Email Address Telephone # Is your relation
Institution Name Academic or
Professional?
Name and position of any relative working in this institution:
__________________________________________________________________________________
Checklist for Applicant:
Please attach copies of the following documents with your personal information form:
1. Two copies of Computerized National Identity Card.
2. Four colored photographs.
3. Copies of all educational documents.
4. Copies of all experience certificates.
5. Copy of CV/Bio-Data.
6. Passport Photocopies if CNIC is not available
7. COVID-19 Vaccination Certificate (Mandatory)
8. Pakistan Medical & Dental Council Registration (If Applicable)
9. Pakistan Nursing Council Card (PNC) (If Applicable)
10. Other (Please specify)
______________________________________________________
The above-mentioned documents should be complete in all respects.
Please Read This Statement Carefully
I declare that the information given in the application is true and to the best of my knowledge and I
understand that a false statement will be considered sufficient case of dismissal from employment.
Name: ________________________ Signature: __________________ Date: ________________
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