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Application Form | ||||
| Name of Candidate | Pankaj Kumar Jha |
911041010060 
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| Mother's Name | Rita Devi | |||
| Father's Name | Vibhash Chandra Jha | |||
| Date of Birth * | 08-Oct-1998 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | AT+PO: BHRAMARPUR P.S: BIHPUR BHAGALPUR 853201 | |||
| Mobile No. | 7654656912 | |||
| Email Address | PJHA5358@GMAIL.COM | |||
Course Details |
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| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
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| Center Code | 91104101 | |||
| Center Name | Sterliate Training Institute | |||
| Center Address | Adampur chowk | |||
| 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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