Application Form

Name of Candidate Dipak Kumar
911041570116

Student Photo Not Available
Mother's Name Sunita Devi
Father's Name Rameshwar Sah
Date of Birth * 01-May-2000
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Novtoliya po- timtanka diyara thana rangra chowk Tintanga bhagalpur Bihar - 853205
Mobile No. 6206989764
Email Address tintanganv4580@gmail.com

Course Details

Course Name /Code Certificate In Computer Typing (CT)
Course Duration 6 Months

Center Details

Center Code 91104157
Center Name Vivek Computer Classes
Center Address Barari,Near ITI College
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: _______________

Date : _______________
Authorized Signatory