Application Form

Name of Candidate Rupesh Kumar
911041570420

Student Photo Not Available
Mother's Name Rita Sinha
Father's Name Jagdish Prasad Srivastav
Date of Birth * 05-Oct-1994
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Adarsh colony bari khanjarpur bhagalpur Bihar - 812001
Mobile No. 9661802663
Email Address rupeshraj9661@gmail.com

Course Details

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

Center Details

Center Code 91104157
Center Name Vivek Computer Classes
Center Address Barari,Near ITI College
Decleration

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

Place: _______________

Date : _______________
Authorized Signatory