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Application Form | ||||
| Name of Candidate | Vimlesh Kumar Mahto |
911020350070 
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| Mother's Name | Gaudi Devi | |||
| Father's Name | Ramchandra Mahto | |||
| Date of Birth * | 20-Mar-1994 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Vill-Turkaulia,po-Serwa masjidwa,ps- Matiyaria,pin- 845455,Dist-west champaran -Bihar 845455 | |||
| Mobile No. | 8789255039 | |||
| Email Address | vimleshkm.94@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 | 91102035 | |||
| Center Name | Evergreen Computer Institute | |||
| Center Address | Amarpur | |||
| 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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