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Application Form | ||||
| Name of Candidate | Ketan Kumar Jha |
911078460046 
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| Mother's Name | Jaymala Devi | |||
| Father's Name | Amod Kumar Jha | |||
| Date of Birth * | 08-Jan-1997 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | AT+PO- BASAUNA, WARD NO-11, SAHARSA,BIHAR,852202 | |||
| Mobile No. | 7979015017 | |||
| Email Address | ketan2ketan@gmail.com | |||
Course Details |
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| Course Name /Code | Certificate In Computer Typing (CT) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91107846 | |||
| Center Name | Tejas Computer Institute | |||
| Center Address | Parwiniya ,Sonbarsa Kachari Road | |||
| 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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