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Subject - punjab pharmacy council, lahore

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To<br />

PUNJAB PHARMACY COUNCIL, LAHORE<br />

(Established under Pharmacy Act, 1967)<br />

THE SECRETARY,<br />

PUNJAB PHARMACY COUNCIL,<br />

LAHORE.<br />

APPLICATION FORM FOR REGISTRATION AS PHARMACY ASSISTANT<br />

(REGISTRATION IN REGISTER “B”)<br />

SUBJECT:-REGISTRATION AS PHARMACY ASSISTANT<br />

Attested<br />

Photograph to be<br />

pasted here by the<br />

applicant<br />

Sir,<br />

I hereby submit that I appeared in the examination of Pharmacy Assistant conducted by Punjab<br />

Pharmacy Council under section 29 of Pharmacy Act, 1967 amended in 1973 held in _______________<br />

under Roll No. ________________ And was declare successful. I therefore apply for registration<br />

<strong>pharmacy</strong> assistant in register ‘’B’’ of Punjab Pharmacy Council.<br />

My particulars are as follows:-<br />

1. Name (Block Letter): _______________________________________________________<br />

2. Father’s Name: ______________________________________________________________<br />

3. Permanent Address: __________________________________________________________<br />

__________________________________________________________________________<br />

4. Professional Address: __________________________________________________________<br />

__________________________________________________________________________<br />

5. Enrollment Certificate No. ____________________________________________________<br />

__________________________________________________________________________<br />

6. Mark of Identification: _______________________________________________________<br />

The prescribed fee of Rs. 1000 has been remitted by Demand Draft / Cash/<br />

No _____________, Dated___________________<br />

Yours Obediently<br />

Signature: _________________<br />

Dated: ___________________<br />

Instruction:<br />

Following document t be submitmued along with the application form:<br />

1. Photostat copy of Enrollment Certificate C (if any)<br />

2. 3 Attested passport size photographs<br />

3. Photostat copy of Result Card<br />

4. Specimen Signatures. 3<br />

5. Affidavit as per specimen given overleaf on Non-Judicial paper of Rs. 20 duly attested by Oath<br />

Commissioner / Gazetted Officer.<br />

6. Fee of Rs. 1,000 will be accepted by Cash/Demand Draft

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