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Application Form | ||||
| Name of Candidate | Pallabi Kumari |
911041520262 
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| Mother's Name | Benju Devi | |||
| Father's Name | Rambalak Roy | |||
| Date of Birth * | 10-Jun-1998 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | At + P.O. - Fatehour, P.s. - Nathnagar, Bhagalpur Pin No. - 812004 | |||
| Mobile No. | 6200503564 | |||
| Email Address | pallviroy141@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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