Application Form

Name of Candidate Gautam Kumar
911029040876

Student Photo Not Available
Mother's Name Sulochana Devi
Father's Name Jaylal Mandal
Date of Birth * 18-May-2002
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Khawashpur diarra urf topra, bhagalpur, bihar, pin:-813209
Mobile No. 6200381808
Email Address sharvankumar1270@gmail.com

Course Details

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

Center Details

Center Code 91102904
Center Name Computer Training Institute
Center Address Kahalgaon
Decleration

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

Place: _______________

Date : _______________
Authorized Signatory