Shivam Kumar-960707031000

A division of
OM Computer Training Institute
Regd. Under Companies Act | Ministry of Corporates Affairs Govt of India
Regd Office : E-84, Gali No. 4, New Ashok Nagar, Near Dashmesh Public School, Vasundhra Enclave, New Delhi, 110096
Application Form

Student Details

Name of Candidate : Shivam Kumar
Reg. No. 960707031000

Student Photo Not Available
Mother's Name : Ragni Pandey
Father's Name : S N Pandey
Date of Birth * : 31-Aug-2000
Gender : MALE
Nationality : INDIAN
Present Address : S/O S N Pandey, Ward-16,Madhavnagar,Mananpur,Mursand,Runnisaidpur, District: Sitamarhi, State:Bihar, PIN-843328
Mobile No. : 8936810313
Email Address : shivampanday033@gmail.com

Course Details

Course Name /Code : Certificate in Computer Application (CCA)
Course Duration : 3 Months

Attached Document

Identity Proof : Sorry No Attachment
Educational Certificate : Sorry No Attachment
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: , East Delhi
Date : 15-Apr-2025

Signature of Student

Center Details

Center Code : 96070703

Verified By
Center Name : OM Computer Training Institute
Center Address : E-84, New Ashok Nagar, Delhi-110096, (East Delhi)
ID Proof
Educational Proof