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Application Form | ||||
| Name of Candidate | Ketan Raj |
911041020013 
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| Mother's Name | Kiran Kumari | |||
| Father's Name | Krishna Chandra Das | |||
| Date of Birth * | 07-Apr-1994 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | sikanderpur kobivadi chandi prasad lane near reliance tower mirjanhat bhagalpur 812005 | |||
| Mobile No. | 7488327748 | |||
| Email Address | rajketan232@gmail.com | |||
Course Details |
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| Course Name /Code | Master Diploma in Computer Teacher Training (MDCTT) | |||
| Course Duration | 15 Months | |||
Center Details |
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| Center Code | 91104102 | |||
| Center Name | Sterliate Training Institute | |||
| Center Address | Khanjarpur | |||
| 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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