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Application Form | ||||
| Name of Candidate | Pushpa Kumari |
911052220008 
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| Mother's Name | Shobha Devi | |||
| Father's Name | Ram Naresh Pandit | |||
| Date of Birth * | 12-Oct-1994 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | W O-Brajesh kumar Prajapati, Rampurwa, Post-Barmaswa, Ward no.1 Harsidhi, Turkauliya, East Champaran. | |||
| Mobile No. | 9507000675 | |||
| Email Address | ||||
Course Details |
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| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
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| Center Code | 91105222 | |||
| Center Name | PDS Computer Education | |||
| Center Address | Motihari | |||
| 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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