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Application Form | ||||
| Name of Candidate | Kaushik Kumar |
911079150031 
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| Mother's Name | Jaimala Devi | |||
| Father's Name | Kailash Prasad Mehta | |||
| Date of Birth * | 11-Jul-1988 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | AT-KUMARPUR,P.O-MANJOURA,P.S-BIHARIGANJ,MADHEPURA BIHAR 852116 | |||
| Mobile No. | 9123198755 | |||
| Email Address | 15kaushikmehta51@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 | 91107915 | |||
| Center Name | Apex Computer Centre | |||
| Center Address | Bihariganj-852101 | |||
| 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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