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Application Form | ||||
| Name of Candidate | Shalu Kumari |
911041392986 
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| Mother's Name | Rashna Devi | |||
| Father's Name | Ranjeet Kumar Ray | |||
| Date of Birth * | 12-Feb-2004 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Vill-tulsipur, post-tulsipur, thana-kharik, dist-bhaglpur, Bihar,853202 | |||
| Mobile No. | 9608105071 | |||
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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 | 91104139 | |||
| Center Name | Lord Buddha Computer Training Centre | |||
| Center Address | Adampur | |||
| 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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