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Leave Application Form - DBM

This document is a leave application form for students in the Department of Economics at the University of the Punjab. It requires personal details, type of leave, leave dates, and evidence for the leave, with specific sections for medical and general leave. The form also includes a declaration of accuracy and authenticity of the provided information.

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26 views1 page

Leave Application Form - DBM

This document is a leave application form for students in the Department of Economics at the University of the Punjab. It requires personal details, type of leave, leave dates, and evidence for the leave, with specific sections for medical and general leave. The form also includes a declaration of accuracy and authenticity of the provided information.

Uploaded by

rubabh92
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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Department of Economics, University of the Punjab

LEAVE APPLICATION FORM


Name: _______________________________ CNIC: ________________Roll No.: ___________

Session: ____________ Semester: ______ Contact: ________________ Morning Replica

LEAVE DETAILS AND EVIDENCE RECORD


# ITEM RESPONSE
1 Type of Leave (tick): Medical Leave General Leave
2 Leave Dates (From - To) _______________________ to ______________________

FOR GENERAL LEAVE ONLY


3 Total Leave Duration (in days)
4 Reason for Leave:

5 Is Evidence Attached? (e.g.; death Yes No


certificate, Travel Tickets, etc.)

FOR MEDICAL LEAVE ONLY


6 Medical Certificate Original? Yes No
7 Recognized Government or Private Hospital? Government Private
8 For Government: Doctor’s signature and stamp present? Yes No
9 For Private: Medical Superintendent’s signature and stamp Yes No
present?

Declaration
I hereby declare that the above information is accurate and all evidence provided is authentic.

Signature of Student (Applicant): _____________________ Date: _____________________

Program Assistant, BS(Economics)

Program Coordinator, BS(Economics)

Chairman, Department of Economics

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