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Application Form | ||||
| Name of Candidate | Shahjad Ansari |
911052220461 
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| Mother's Name | Shayda Khatun | |||
| Father's Name | Tahir Ansari | |||
| Date of Birth * | 19-Mar-1998 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | S/O Tahir Ansari, Gram - jaysinghpur, Tirkauliya, East Champaran Bihar 845437 | |||
| Mobile No. | 8579882308 | |||
| Email Address | shahjadansari823@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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