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Application Form | ||||
| Name of Candidate | Gautam Kumar Verma |
911012510211 
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| Mother's Name | Kaushami Devi | |||
| Father's Name | Siyaram Prasad | |||
| Date of Birth * | 15-Apr-1995 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | add-vill-kori bigha, gaya, pakari, bihar-824205 | |||
| Mobile No. | 9308795189 | |||
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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 | 91101251 | |||
| Center Name | CIT Computer Education | |||
| Center Address | Bihar Sharif | |||
| 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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