Application Form

Name of Candidate Kaushik Kumar
911079150032

Student Photo Not Available
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 ward no-13,kumarpur,madhepura-852116
Mobile No. 9123198755
Email Address 15kaushikmehta51@gmail.com

Course Details

Course Name /Code Certificate In Computer Typing (CT)
Course Duration 6 Months

Center Details

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.

Place: _______________

Date : _______________
Authorized Signatory