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Application Form | ||||
| Name of Candidate | Ankur Kumar Roy |
911041520229 
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| Mother's Name | Sunita Devi | |||
| Father's Name | Tetar Roy | |||
| Date of Birth * | 18-Aug-2000 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Vill-Singhpur, P/O- Gobrain, P/S- Sajour, District - Bhagalpur (Bihar) Pin code - 812006 | |||
| Mobile No. | 6203187412 | |||
| Email Address | ankurkumarroy8@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 | 91104152 | |||
| Center Name | Evergreen Computer Training Institute | |||
| Center Address | Nathnagar | |||
| 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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