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Application Form | ||||
| Name of Candidate | Gaurav Kumar |
911041570965 
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| Mother's Name | Gita Devi | |||
| Father's Name | Subhash Prasad Modi | |||
| Date of Birth * | 05-Jan-1995 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Ward no - 26 nandlal Mishra lane khanjarpur low college ke piche bhagalpur Bihar - 812001 | |||
| Mobile No. | 9771558612 | |||
| Email Address | kumargaurav.9070@gmail.com | |||
Course Details |
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| Course Name /Code | Certificate In Computer Typing (CT) | |||
| Course Duration | 6 Months | |||
Center Details |
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| 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. |
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Place: _______________ Date : _______________ |
Authorized Signatory |
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