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Application Form | ||||
| Name of Candidate | Maherukh Imam |
911041140269 
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| Mother's Name | Bibi Shahnaz | |||
| Father's Name | Md Mahir Imam | |||
| Date of Birth * | 02-Nov-2001 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | at+po- fatehpur, ward-3,sabour bhagalpur, 813210 | |||
| Mobile No. | 7991122113 | |||
| Email Address | ||||
Course Details |
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| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91104114 | |||
| Center Name | CTI | |||
| Center Address | NH-80, Opp.Tata Motors, Sabour | |||
| 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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