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Application Form | ||||
| Name of Candidate | Mohammad Khalid Perwez |
911052220431 
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| Mother's Name | Saleha Khatoon | |||
| Father's Name | Mohammad Jalaluddin | |||
| Date of Birth * | 26-Jan-1991 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | S/o Mohammad Jalaluddin, pakahi, andhara, adapur, ramgarwa, East champaran Bihar 845433 | |||
| Mobile No. | 9709894001 | |||
| Email Address | kperwez585@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 | 91105222 | |||
| Center Name | PDS Computer Education | |||
| Center Address | Motihari | |||
| 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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