Application Form

Name of Candidate Padmnabh Captain
911041400021

Student Photo Not Available
Mother's Name Sarita Devi
Father's Name Animesh Kumar
Date of Birth * 10-Dec-1998
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Nearby Hanuman mandir, B tola ishakchak Bhagalpur -812001
Mobile No. 9905859132
Email Address padmnabhcaptain@gmail.com

Course Details

Course Name /Code Certificate In Computer Typing (CT)
Course Duration 6 Months

Center Details

Center Code 91104140
Center Name Computer Institute of Technology
Center Address Mirjanhat
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: _______________

Date : _______________
Authorized Signatory