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Application Form | ||||
| Name of Candidate | Gouri Shankar Das |
911041051499 
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| Mother's Name | Sangita Devi | |||
| Father's Name | Anandi Ravi Das | |||
| Date of Birth * | 16-Dec-1995 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | AT + POST - MIRHATTI, PS - SULTANGANJ, DIST - BHAGALPUR, BIHAR, 813213 | |||
| Mobile No. | 9568396218 | |||
| Email Address | gsdas789@gmail.com | |||
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 | 91104105 | |||
| Center Name | Lord Buddha Computer Institute | |||
| Center Address | Sultanganj | |||
| 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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