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Application Form | ||||
| Name of Candidate | Sangam |
910711630080 
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| Mother's Name | Mrs.rinku Devi | |||
| Father's Name | Mr. Binod Kumar Mahto | |||
| Date of Birth * | 09-Jan-2005 | |||
| Gender | FEMALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Plot no -4,KH No- 282,Village- Dallupura,Vasundhara enclave,East Delhi- 110096 | |||
| Mobile No. | 9625220490 | |||
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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 | 91071163 | |||
| Center Name | Raj Computer Training Centre | |||
| Center Address | Dallupura | |||
| 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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