PATEL HOSPITAL

A PROJECT OF PATEL FOUNDATION

Street 18, Block 4, Gulshan-e-Iqbal, Karachi Pakistan.

EMPLOYMENT APPLICATION FORM

Post applied for: ________________________________________

PERSONAL INFORMATION
Name (in block letter): ____________________________________
Fathers / Husband name: __________________________________
Present Address: ________________________________________________________________
Home Phone: ____________________________ Mobile: _______________________________
Permanent Address: ______________________________________________________________
Date of Birth: ____________________________ Place of Birth:
__________________________
Marital Status: ______________ No of Children: _______________ Gender:
______________
Religion: ___________________ Domicile: ____________________
CNIC: ________________________________ E-mail: __________________________________
Have you any relative in Patel Hospital: __________________________
P.M.D.C Registration No: ______________________________________
P.M.A Registration No: ________________________________________
Pakistan Nursing Council Registration No: _________________________
Midwifery Registration No: _____________________________________

ACADEMIC QUALIFICATION
Degree
Matriculation
Intermediate
Graduation
S#
Employer
Masters
01
Other
02

Passed Year

Position
Held

Grade / Div

Period
From

Board /

Subjects

University

Last
To

Salary

Reason
for
Leaving

03
04
05

Computer Literacy: _______________________________________________________________

PREVIOUS EMPLOYMENT RECORD

PERSONAL REFERENCES
S#

Name

Address

Phone / Mobile

01
02
03

Date: _______/_________/__________

FOR OFFICE USE ONLY

Following the evaluation and recommendation of the interviews, the above named
candidate is appointed as ______________________________ with effect from the dare
he / she report for duty, and submits joining report through departmental head.

Salary

Duty Hours

Joining Date

Rs.

___________________________
Human Resource Manager

_____________________
Head of Department

_______________
Administrator

________________
Medical Director