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Application Form | ||||
| Name of Candidate | Rangita Hembram |
911029420002 
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| Mother's Name | Hupanmoy Devi | |||
| Father's Name | Sanjay Hembram | |||
| Date of Birth * | 01-Jan-2002 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | AT KAJHA, PO MADARGANJ, PS AMDANDA, BHAGALPUR, BIHAR 813204 | |||
| Mobile No. | 8862948638 | |||
| Email Address | rohitclg888@gmail.com | |||
Course Details |
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| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91102942 | |||
| Center Name | Computer Training Institute | |||
| Center Address | Ghuthiyani,Kahalgaon | |||
| 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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