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Application Form | ||||
| Name of Candidate | Anujamod Ashish |
911041140299 
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| Mother's Name | Aruna Devi | |||
| Father's Name | Dashrath Prasad Sharma | |||
| Date of Birth * | 01-Mar-1985 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | at+po- bharatkhand,ward no. -02, ps- parbatta, dist- khagaria, 853203 | |||
| Mobile No. | 9262986702 | |||
| Email Address | aanujamod@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 | 91104114 | |||
| Center Name | CTI | |||
| Center Address | NH-80, Opp.Tata Motors, Sabour | |||
| 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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