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Application Form | ||||
Name of Candidate | Ankita Ranjan |
911008010642 |
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Mother's Name | Annapurna Ghosh | |||
Father's Name | Ratan Kuamr Ghosh | |||
Date of Birth * | 30-Oct-1992 | |||
Gender | FEMALE | |||
Nationality | INDIAN | |||
Present Address | AT+PO LAKHANPUR PS TARAPUR DIST MUNGER PIN CODE 813201 | |||
Mobile No. | 7541924792 | |||
Email Address | ||||
Course Details |
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Course Name /Code | Advance Diploma in Beautician (ADB) | |||
Course Duration | 12 Months | |||
Center Details |
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Center Code | 91100801 | |||
Center Name | Maa Kalyani Computer Centre | |||
Center Address | Asarganj | |||
Date of Admisison | 01-Jan-1970 | |||
Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
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Place: _______________ Date : _______________ |
Authorized Signatory |