Temporary – Imran Idrees Group Alumni

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SECTION I: GRADUATE IDENTITY & DEGREE RECORD

1. Full Name *

(exactly as to appear on degree and be announced)

2. Father’s / Guardian’s Name *

3. CNIC / B-Form Number *

4. UHS Registration Number *

5. College Roll Number *

6. MBBS Batch *

MBBS 2015-2020
MBBS 2016-2021
MBBS 2017-2022
MBBS 2018-2023

7. Contact Number *

8. Email Address *

(official correspondence)

SECTION II: ACADEMIC HONORS, DISTINCTIONS & UHS POSITIONS

(This section is strictly for official record and award consideration)

1. Have you been awarded any academic distinction during MBBS? *

2. If yes, specify the distinction(s) clearly. (e.g., Subject Distinction, Overall Distinction, etc.) *

Anatomy 1
Physiology 1
Biochemistry 1
Anatomy 2
Physiology 2
Biochemistry 2
Pharmacology
Forensic Medicine
Pathology
Behavior Science
Community Medicine
Special Pathology
ENT
EYE
Medicine and Allied
Surgery and Allied
Obstetrics and gynecology
Pediatrics

3. Have you secured any position at the University of Health Sciences (UHS)? *

5. Have you secured any position at the College (SMC)? *

7. Upload Transcript / Result Notification *

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Upload Transcript / Result Notification for Verification (File Upload (PDF / clear scanned copy)

SECTION III: GUEST DETAILS

Guest Policy
Registration fee covers the graduate + two guests (total three persons).
Registration Fee: PKR 10,000
Additional Guests: PKR 5,000 per guest
Children below 10 years are not allowed

1. Total Number of Guests Attending (excluding graduate) *

No Guests
1 Guest
2 Guests
More than 2 Guests

2. Guest Information (Mandatory)

Guest 1

Full Name *

Relationship with Graduate *

CNIC *

3. Guest 2

Full Name *

Relationship with Graduate *

CNIC *

4. Additional Guest(s) (if applicable)

Full Name *

Relationship with Graduate *

CNIC *

1. Upload Proof of Fee Payment (Receipt)

Guest Policy
Registration fee covers the graduate + two guests (total three persons).
Registration Fee: PKR 10,000
Additional Guests: PKR 5,000 per guest
Children below 10 years are not allowed

Before submitting this form, please deposit the applicable registration amount into the following bank account using your online banking app or by visiting a bank branch:

Bank Name: Allied Bank Ltd.
Account Title: Sialkot Medical College (Pvt.) Ltd.
Account Number: 0010031411170016
IBAN: PK59ABPA0010031411170016

After completing the payment, please attach a clear screenshot of the transaction receipt in the form as proof of payment.

File Upload *

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Declaration *

Declaration

I hereby certify that all information provided in this form is true, complete, and accurate. I understand that any academic distinction, medal, shield, or honor shall be awarded strictly after verification of official records. I further acknowledge the fee structure and guest policy of the Convocation Ceremony.