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College of Physicians & Surgeons Pakistan: Online Application Form (FCPS-I) Examination

Usama Bilal Ahmad applied online to take the FCPS-I examination in September 2020 in Medicine and Allied speciality at the Multan examination center. He paid a fee of PKR 15,600 which included an exam fee of PKR 15,050 and bank service charges of PKR 550 using his debit/credit card. He received an electronic receipt from the College of Physicians and Surgeons Pakistan as confirmation of his application and fee payment.

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Usama Bilal
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140 views2 pages

College of Physicians & Surgeons Pakistan: Online Application Form (FCPS-I) Examination

Usama Bilal Ahmad applied online to take the FCPS-I examination in September 2020 in Medicine and Allied speciality at the Multan examination center. He paid a fee of PKR 15,600 which included an exam fee of PKR 15,050 and bank service charges of PKR 550 using his debit/credit card. He received an electronic receipt from the College of Physicians and Surgeons Pakistan as confirmation of his application and fee payment.

Uploaded by

Usama Bilal
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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College of Physicians & Surgeons Pakistan Fresh

Form No: 772-228602


7th Central Street, Defence Housing Authority, Karachi -75500, Pakistan
Tel: 9207100-09 , Fax: 9207120, 5881444, UAN: 111-606-606
Website: www.cpsp.edu.pk

Online Application Form (FCPS-I) Examination

Term: 29-SEP-2020
Registration Type: Fresh
Examination Center: MULTAN
Selected Speciality: MEDICINE AND ALLIED
Fee Type: Debit/Credit Card Fee Amount PKR 15050
Fee Submission City Lahore Transaction ID: 212865485250
Receipt #: LHR-O-20-14006 Receipt Date: 12-07-2020

Profile Information
Medical Reg. No: 106990-P
Medical Reg. issue date: 20-02-2019 Medical Reg. expiry date: 31-12-2021
Full Name: USAMA BILAL AHMAD
Father's name: BILAL AHMAD
Nationality: Pakistan Identity Card No: 31102-2800875-9
Gender: Male Marital Status: Single
Date of Birth: 25-09-1989
Email: [email protected]

Present/Mailing Address (Residential Only)


Address: HOUSE # 97, BEHIND FATIMA PLAZA OLD EID GAH ROAD
Chishtian, Punjab, Pakistan
Tel (Res.): 0632440077 Tel (Office):
Cell: 03007877132 Postal Code:

Permanent Address (Residential Only)


Same as Mailing Add: Yes
Address: HOUSE # 97, BEHIND FATIMA PLAZA OLD EID GAH ROAD
Chishtian, Punjab, Pakistan
Tel (Res.): 0632440077 Tel (Office):
Cell: 03007877132 Postal Code:

Professional Qualification
Degree: MBBS Passing Year: 2017
Institute:
City/State/Country: Lahore, Punjab, Pakistan

Declaration
do hereby declare that information given above is correct to the best of my knowledge. Incorrect information may lead to cancelation of enrollment /
admission / results and disciplinary action.

Signature of Candidate: ________________________________


Dated: 12-07-2020

Note:

Once entered in the application the center and subject will only be changed after submission of prescribed fee for this change.

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ORIGINAL - Concerned Department DUPLICATE - Applicant

College of Physicians and Surgeons Pakistan College of Physicians and Surgeons Pakistan

Debit/Credit Card Debit/Credit Card

Center: Lahore PMDC/En.No: 106990-P Center: Lahore PMDC/En.No: 106990-P


Receipt #: LHR-O-20-14006 Date: 12-07-2020 Receipt #: LHR-O-20-14006 Date: 12-07-2020
Name: USAMA BILAL AHMAD Name: USAMA BILAL AHMAD
Trans ID: 212865485250 Approval Code: 051097 Trans ID: 212865485250 Approval Code: 051097

Form No: 772-228602 Form No: 772-228602

Fee Type Session Amount Fee Type Session Amount

Exam Fee - FCPS-I SEP-2020 PKR 15050 Exam Fee - FCPS-I SEP-2020 PKR 15050

Bank Service Charges PKR 550 Bank Service Charges PKR 550

Total: PKR 15600 Total: PKR 15600

Amount in words: Fifteen Thousand Six Hundred Only (PKR) Amount in words: Fifteen Thousand Six Hundred Only (PKR)

Note: Note:
In case of any refund/charge back against cards transaction through internet payment In case of any refund/charge back against cards transaction through internet payment
gateway, the candidate should claim the refund/charge back from CPSP directly. gateway, the candidate should claim the refund/charge back from CPSP directly.

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