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Application Form | ||||
| Name of Candidate | Md Shamul Fakhre Alam |
911041780495 
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| Mother's Name | Bibi Halima Khatoon | |||
| Father's Name | Md Shahab Uddin | |||
| Date of Birth * | 05-Jun-1979 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | West mojahidpur p.o.-city post office Jagdishpur ,po-bhagalpur city dist-bhagalpur Bihar 812002 | |||
| Mobile No. | 9523357975 | |||
| Email Address | shamulchand753@gmail.com | |||
Course Details |
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| Course Name /Code | Post Graduate Diploma in Computer Application (PGDCA) | |||
| Course Duration | 15 Months | |||
Center Details |
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| Center Code | 91104178 | |||
| Center Name | Lord Buddha Educational Trust | |||
| 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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