1

UNIVERSITY OF SARGODHA
Admission Form for Pharm-D (5 Years Course) (Annual System)

Mention Professional___________________

The Candidate
Regular Late College Fresh Compartment / Failed as a whole must paste here a
recent coloured
( T i c k t h e r e l e v a n t b o x e s ) photograph
1. Name of College _______________________________________________
Do not staple or
2. Registration No. University of Sargodha pin up

3. Name of the Candidate (in block letters) Form No. __________

6. Religion ________________ 7. Nationality ____________ 8. Sex (Male or Female)

9. Name of City / Town opted for Centre __________________________________________________

10.
Information about F.Sc. or equivalent Examination Passed:
st nd
1 or 2
Examination Year Roll No. Marks Division Board
Annual

Information about Latest Passed Exam: (only for 2nd, 3rd, 4th & 5th Professional Students)
1st or 2nd
Examination Year Roll No. Marks University
Annual

11. Present Address (in block letters) _____________________________________________

_____________________________________________
12. Permanent Address (in block letters) _____________________________________________
_____________________________________________
13. Mention Subjects in which to appear
i. _____________________________ iv. ________________________ vii. __________________________

ii. _____________________________ v. ________________________ viii. __________________________

iii. _____________________________ vi. ________________________ xi. __________________________

xi. _____________________________ xi. ________________________ xii. __________________________

14. For Compartment / Failed as a Whole candidates only (information about the last chance availed)

Year of last appearing in Pharm-D _________ Prof. ________ Annual Exam, 200 ___ Under
1st or 2nd
Roll No. ______
Declaration:
1. I declare that all the particulars mentioned above are correct and in case of any difficulty
arising out of inaccuracy therein, I shall be responsible for the same.
2. I shall not take part in walk out or protest in any paper during the examination.

Signature of the Candidate ___________ Signature of Principal

With office Stamp
Rupees. Rs. 30
Online downloaded
 2

UNIVERSITY OF SARGODHA Form No. ______

ADMISSION FORM
PHARM-D (5 YEARS COURSE) (Annual System)
Mention Professional.__________
Mention First Annual or Second Annual Examination 20 ____.
THE CANDIDATE IS DIRECTED TO READ AND COMPLY WITH THE
INSTRUCTIONS PRINTED AT PAGE 3 CAREFULLY BEFORE FILLING IN THE
ADMISSION FORM. INCOMPLETE ADMISSION FORM SHALL BE REJECTED
AND RETURNED FORTHWITH. THE UNIVERSITY SHALL NOT TAKE ANY Paste one
RESPONSIBILITY FOR THE CONSEQUENCES. PARTICULARS MENTIONED attested recent
BELOW ARE TO BE FILLED IN BY THE CANDIDATE NEATLY AND LEGIBLY IN coloured photo
HIS / HER OWN HAND WRITING WITH BLUE BALLPOINT / PEN.
Male / Female
1. Name of the College ________________________________________
2. Registration No. _________________________

3. Name of the Candidate in English __________________________________________________

(Block Letters)
4. National I.D Card No. ____________________________________________________________
5.
(Block Letters)
6. Male or Female _______________ 6. Religion __________ 7. Nationality ________________
7. Fee Paid Rs. _________________ Bank Challan No. _______________ Dated _____________
Habib Bank Ltd. Branch _________________________________
8. City / Town opted for the Examination Centre ________________________
9. Names of compulsory / optional papers in which to appear.
Compulsory / Optional Papers
i). _________________________________ ii). ________________________________
iii). _________________________________ iv). ________________________________
v). _________________________________ vi). ________________________________
vii). _________________________________ viii). ________________________________
ix). _________________________________ x). ________________________________
xi). _________________________________ xii). ________________________________

10. The year of passing F.Sc. or equivalent Examination 1st or 2nd Annual______________________
Roll No. _____________ Name of the Board _________________________________________
11. Information about Latest Passed Exam: The year of passing Pharm-D. ___________ Professional, 1st /2nd
Annual Examination 20 ___ Roll No. _________marks obtained __________ (Only for 2nd, 3rd, 4th, 5th
Professional candidate)
13. FOR EXEMPTION / COMPARTMENT CANDIDATES WHO HAVE ALREADY APPEARED IN
PHARM-D EXAMINATION AND FAILED.
Year of appearing in Pharm D __________. Professional _____ 1st /2nd Annual Examination ________ under Roll
No. ____________ and eligible to reappear in Paper/s.
1. ________________________________ 2. _______________________________
3. ________________________________ 4. _______________________________
5. ________________________________ 6. _______________________________
7. ________________________________ 8. _______________________________
Declaration: - I hereby declare that:- 1) All the particulars mentioned above are correct and that in case of any
difficulty arising out of inaccuracy therein, I shall be responsible for the consequences.
2. I shall not take part in walkout or protest in any paper during Examination.
3. I have read the instructions carefully given at the back of this page & Roll No. Slip and shall abide by them.

Signature of the Candidate

Permanent Home Address Full Present Address

_____________________________ ________________________________
_____________________________ ________________________________
_____________________________ ________________________________
Price: - 30 Rupees

Online downloaded
 3

IMPORTANT INSTRUCTIONS
1. The candidate is directed to read instructions hereunder before filling in the Admission and Fee Receipt
Forms carefully. The Admission Form will be liable to be rejected if correct Registered No. is not mentioned or
incomplete or incorrect entry is made in the Form. The incomplete Admission Form shall be rejected and returned
forthwith. The University shall not take any responsibility for the consequences.
2. Each candidate (Male / Female) must paste latest passport size Photographs, duly attested at the specified
places in the Admission Form.
3. The Examination begins on the date/s given in the Date Sheet. Every candidate must keep his / her
National Identification Card with him / her in the Examination Hall while taking the Examination.
4. The Admission Form will be entertained only if the attested photocopy of the Registration Card, issued by
the University, is attached with the Form alongwith other documents.
5. The candidates must attach attested copies of latest pass result card and Computerized National Identity
Card. The compartment/ failed as a whole candidates must attach attested copy of latest fail result card and
Computerized National Identity Card.

CERTIFICATE FOR REGULAR STUDENTS

Certified that the applicant has fulfilled the conditions laid down under the statutes enforced in the year of
Examination and that:
a) The student concerned has been on the rolls of the College during the academic year immediately
preceding the Examination.
b) He has attended, not less than two third of the total number of lectures delivered to his class in each paper,
separately in theory and practical, during the academic year immediately preceding the Examination.
c) His performance, as judged through class tests, assignments etc. has been satisfactory.
d) His / Her character and conduct have been good.
e) He / She has, passed F.Sc/ previous professional exams in accordance with the prescribed Regulations.
f) He / She has filled in and signed the Admission Form in my presence, and the particulars filled in by him /
her on the reverse are correct and nothing has been concealed.

CERTIFICATE FOR LATE COLLEGE STUDENTS

a) The late College student concerned was on the rolls of the College during the academic year_____.
b) He / She attended, not less than two third of the total number of lectures delivered to his class, in each
paper, separately in theory and practical during the academic year ___________________.
c) His / Her performance as a regular student judged through class tests, assignments etc., was satisfactory.
d) His / Her character and conduct have been good.
e) He / She has passed F.Sc /previous professional exam in accordance with the prescribed Regulations.
f) He / She has filled in and signed the Admission Form in my presence, and the particulars filled in by him /
her on the reverse are correct and nothing has been concealed.

FOR THE LATE COLLEGE CANDIDATE PLACED UNDER COMPARTMENT / EXEMPTION

He / She appeared in Pharm-D. _______ Prof. 1st /2nd Annual Examination 200 ____ under Roll No. ___________ and
was placed in compartment or earned exemption and is eligible to reappear in the following paper/s.
____________________________________________________________________________
___________________________________________________________________________________

Signature of the Principal

Stamp of the Principal

Dated _______________

Online downloaded
 4

UNIVERSITY OF SARGODHA Form No. ______

FEE RECEIPT FORM
PHARM-D (5-YEARS Course) (Annual System)
Mention Professional _______________
Roll No. _________
Mention First Annual or Second Annual Examination 20 ____. (To be filled in by the office)

IMPORTANT INSTRUCTIONS
1. The candidate is directed to fill in the Admission and Fee Receipt Forms carefully.
Incomplete forms shall be rejected and returned forthwith. The Forms will be considered to have
reached the University Office when these are received complete in all respects. In all other cases,
late fee/double fee will be charged accordingly.
2. The fee is payable through the prescribed Branches of Habib Bank Ltd. on the Challan
prescribed for the University of Sargodha. Money Orders, Postal Orders, Bank Drafts and cheques
shall not be accepted.

1. Name of the Candidate in English __________________________________________________

(Block Letters)
2.
3. Registration No. ______________________
5. FOR EXEMPTION / COMPARTMENT CANDIDATE WHO HAVE ALREADY APPEARED IN
Pharm-D. ____ PROFESSIONAL EXAMINATION AND FAILED.
Year of appearing in Pharm-D. _____ Prof. 1st /2nd Annual ______ Examination under Roll No. ______ .

6. Fee paid Rs. ______________ Bank Challan no. ______________ Dated __________________
Name of Bank and Branch ________________________________________

NOTE: - ORIGINAL RECEIPT OF BANK CHALLAN MUST BE PASTED ON THE BACKSIDE

OF THIS FORM
I hereby declare that all the particulars mentioned above are correct and that in case of any difficulty arising
out of inaccuracy therein, I shall be responsible for the consequences.

Signature of the Candidate

Dated _________________ Full Present Address

________________________________
________________________________
________________________________

Signature of the Principal Stamp of the Principal

Name & Address of the Candidate Name & Address of the Candidate

_________________________________ _____________________________________

_________________________________ _____________________________________

_________________________________ _____________________________________

Online downloaded
 5

TO BE FILLED IN BY THE CANDIDATE

Actual Amount Receipt Amount
Amount Received No. still due
due Rs. Rs. and date Rs.
Examination Fee Pharm-D

Double the ordinary Fee

Reference made by office to the defaulter:-

Letter No. ______________________________________ Dated _________________

1. Reminder No. _____________________________ Dated _________________

2. Reminder ________________________________ Dated __________________

(FEE CHALLAN SHOULD BE PASTED HERE)

Online downloaded