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Application Form | ||||
| Name of Candidate | Pushpendra Kumar Singh |
911024100054 
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| Mother's Name | Rita Devi | |||
| Father's Name | Rakesh Kumar Singh | |||
| Date of Birth * | 01-Mar-2000 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Vill + po - Gulni PS - Shambhuganj District - Banka (Bihar) , Pin - 813211 | |||
| Mobile No. | 7322808298 | |||
| Email Address | piyushchrg@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 | 91102410 | |||
| Center Name | Unique Computer Centre | |||
| Center Address | Gulni Kushaha ,Shambhu Ganj | |||
| 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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