Application Form

Name of Candidate Dhiraj Kumar
911041400073

Student Photo Not Available
Mother's Name Poonam Devi
Father's Name Sabhapati Prasad
Date of Birth * 25-Dec-1993
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Baisa, khagariya, pipra baisa -851212
Mobile No. 9122646077
Email Address d.dhiraj30891@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