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Application Form | ||||
| Name of Candidate | Soni Kumari |
911021110176 
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| Mother's Name | ||||
| Father's Name | Dinesh Ray | |||
| Date of Birth * | 01-Jan-1970 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | japteli, jagatpur, bhagalpur, bihar, pin code=853202 | |||
| Mobile No. | 1234567898 | |||
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Course Details |
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| Course Name /Code | AC Technician (ACT ) | |||
| Course Duration | 4 Months | |||
Center Details |
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| Center Code | 91102111 | |||
| Center Name | Aditya Institute of Information Technology | |||
| Center Address | kharik | |||
| 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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