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Application Form | ||||
Name of Candidate | Bishal Kumar |
911028013042 ![]() |
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Mother's Name | Sumitra Devi | |||
Father's Name | Ram Balak Ram | |||
Date of Birth * | 25-Dec-2005 | |||
Gender | MALE | |||
Nationality | INDIAN | |||
Present Address | VILL- BANKIKHAL, DIST- GOPALGANJ | |||
Mobile No. | 9973921612 | |||
Email Address | bishal@ml.com | |||
Course Details |
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Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
Course Duration | 12 Months | |||
Center Details |
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Center Code | 91102801 | |||
Center Name | Hitech Computer Education | |||
Center Address | Mirganj | |||
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 |