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Application Form | ||||
| Name of Candidate | Kumar Agnivesh |
911041391235 
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| Mother's Name | Asha Pandey | |||
| Father's Name | Rajeev Nayan Panday | |||
| Date of Birth * | 15-Aug-1997 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Prashastdih shankarpur khawas Bhagalpur Bihar pin code-813205 | |||
| Mobile No. | 6200294652 | |||
| Email Address | ||||
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 | 91104139 | |||
| Center Name | Lord Buddha Computer Training Centre | |||
| Center Address | Adampur | |||
| 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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