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Application Form | ||||
| Name of Candidate | Samiksha Kumari |
911024500095 
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| Mother's Name | Pushpa Kumari | |||
| Father's Name | Rakesh Kumar Singh | |||
| Date of Birth * | 10-Jan-2001 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Bhikhanpur, Post-Kapasona, Bethu, Bhagalpur, Kapsona Bihar, 813108 | |||
| Mobile No. | 9608186992 | |||
| Email Address | Samikshakumari58166@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 | 91102450 | |||
| Center Name | Lord Sri Krishna Computer Training Institute | |||
| Center Address | Babura | |||
| 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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