Alok Samal-800703017309

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 : Alok Samal
Reg. No. 800703017309

Student Photo Not Available
Mother's Name : Damayanti Samal
Father's Name : Amar Samal
Date of Birth * : 08-Sep-2010
Gender : MALE
Nationality : INDIAN
Present Address : F-3 gali no. 2/210 sangam vihar new delhi -110080
Mobile No. : 9899668952
Email Address :

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: , South Delhi
Date : 01-Oct-2025

Signature of Student

Center Details

Center Code : 80070301

Verified By
Center Name : OM Computer Training Institute
Center Address : Sangam Vihar, Delhi-80, (South Delhi)
ID Proof
Educational Proof