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Application Form | ||||
| Name of Candidate | Rajnish Kumar |
911041390277 
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| Mother's Name | Shobha Devi | |||
| Father's Name | Bharat Kumar Roy | |||
| Date of Birth * | 04-Sep-1990 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | S O:- Bharat Kumar Roy, Near Shiv Mandir, Kenli PO-Gulni Kushaha, PS-Shambhuganj, Baidpur, Banka, Bihar-813321 | |||
| Mobile No. | 9570445102 | |||
| Email Address | rajnishkumar396@gmail.com | |||
Course Details |
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| Course Name /Code | Certificate In Computer Typing (CT) | |||
| Course Duration | 6 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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