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Application Form | ||||
| Name of Candidate | Lakshmi Rani |
911041190054 
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| Mother's Name | Usha Devi | |||
| Father's Name | Dinesh Pd Sah | |||
| Date of Birth * | 19-Sep-1999 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Ad. - Gram Dumrama po. -Dumrama Amarpur , Banka Bihar - 813101 | |||
| Mobile No. | 9693530526 | |||
| Email Address | ck642000@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 | 91104119 | |||
| Center Name | Amar Computer Classes | |||
| Center Address | Barari | |||
| 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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