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Application Form | ||||
| Name of Candidate | Dr.goutam Kumar Yadav |
911041390118 
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| Mother's Name | Girija Devi | |||
| Father's Name | Siyaram Yadav | |||
| Date of Birth * | 21-Jan-1974 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | At+po- sadhua,ward no- 18 ps- rangra, op- gopalpur , dis- Bhagalpur Bihar Pin code- 853204 | |||
| Mobile No. | 8271222022 | |||
| Email Address | goutamangika74@gmail.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 | 91104139 | |||
| Center Name | Lord Buddha Computer Training Centre | |||
| Center Address | Adampur | |||
| 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 |
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