Shivam Kumar-109160170049

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. 109160170049

Student Photo Not Available
Mother's Name : Manju Devi
Father's Name : Pravesh Kumar
Date of Birth * : 04-Apr-2012
Gender : MALE
Nationality : INDIAN
Present Address : mehani shora
Mobile No. : 9718367507
Email Address : kumaryadavpravesh123@gmail.com

Course Details

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

Attached Document

Identity Proof : Download
Educational Certificate : Download
Decleration

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

Place: , Ghaziabad
Date : 18-Dec-2025

Signature of Student

Center Details

Center Code : 10916017

Verified By
Center Name : OM Computer Training Institute
Center Address : Old Haibatpur, Gzb. U.P., (Ghaziabad)
ID Proof
Educational Proof