Application Form

Name of Candidate Roshan Kumar
911041050880

Student Photo Not Available
Mother's Name Chinta Devi
Father's Name Rajendra Mandal
Date of Birth * 03-Feb-2000
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address AT BHOURKATH PO KOLWARA PS PASRAHA DIST KHAGARIA PIN 851216
Mobile No. 6207002202
Email Address ROSHANKBH7@GMAIL.COM

Course Details

Course Name /Code Diploma in Computer Application (DCA)
Course Duration 6 Months

Center Details

Center Code 91104105
Center Name Lord Buddha Computer Institute
Center Address Sultanganj
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: _______________

Date : _______________
Authorized Signatory