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Application Form | ||||
| Name of Candidate | Kajal Kumari |
911029840001 
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| Mother's Name | Meera Devi | |||
| Father's Name | Pramod Mandal | |||
| Date of Birth * | 10-Jan-2005 | |||
| Gender | MALE | |||
| Enrollment No. | Khg/25/12/db-01/01 | |||
| Nationality | INDIAN | |||
| Present Address | Ward no-12, dayslour,sangitbaita, antichak, bhagalpur,, bihar, pin-813203 | |||
| Mobile No. | 9162588241 | |||
| Email Address | punajsmith@gmail.com | |||
Course Details |
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| Course Name /Code | Diploma in Beautician (DB ) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91102984 | |||
| Center Name | Pallavi Beauty Parlours | |||
| Center Address | Purab tola, Kahalgaon | |||
| 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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