Application Form

Name of Candidate Shubham Kumar
911041400079

Student Photo Not Available
Mother's Name Rita Devi
Father's Name Nandu Ray
Date of Birth * 12-Jan-2003
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Satghara, nearby middle school Bhagalpur -812005
Mobile No. 7546957129
Email Address shubham1133519@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