Pakistan made three injury replacements for the second Test against England in a blow to their hopes of levelling the three-match series in Multan on Friday.
The hosts are already without pace spearhead Shaheen Shah Afridi, who misses the series following an appendicitis surgery, and further injuries have forced them to make three changes.
Fast bowlers Naseem Shah and Haris Rauf are out, along with top-order batsman Azhar Ali.
The home side have replaced them with all-rounders Mohammad Nawaz and Faheem Ashraf and uncapped spinner Abrar Ahmed.
England, who are 1-0 up in the three-test series, had announced their playing 11 on Thursday, bringing in fast bowler Mark Wood for injured all-rounder Liam Livingstone.
"Have to wait and see what it (the pitch) offers but hopefully we can go out and set the same sort of benchmark with the bat," England captain Ben Stokes said after winning the toss and electing to bat.
His Pakistan counterpart, Babar Azam, said he too would have preferred to bat first.
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"The pitch looks dry, we will have to bowl in the right areas," Babar said.
England, on their first test tour of Pakistan since 2005, won the opening match in Rawalpindi by 74 runs.
The final test is scheduled in Karachi from Dec 17.
Pakistan: Imam-ul-Haq, Abdullah Shafique, Babar Azam (captain), Saud Shakeel, Mohammad Rizwan, Agha Salman, Mohammad Nawaz, Faheem Ashraf, Zahid Mahmood, Abrar Ahmed, Mohammad Ali
England: Zak Crawley, Ben Duckett, Ollie Pope, Joe Root, Harry Brook, Ben Stokes (captain), Will Jacks, Ollie Robinson, Jack Leach, Mark Wood, James Anderson