Shibam Biswal-109160150061

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 : Shibam Biswal
Reg. No. 109160150061

Student Photo Not Available
Mother's Name : Kalpana Padhi
Father's Name : Suresh Biswal
Date of Birth * : 04-Jul-2014
Gender : MALE
Nationality : INDIAN
Present Address : gali no 7A Nithari sec-31
Mobile No. : 9871455796
Email Address : omcti180000@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 : 17-Nov-2025

Signature of Student

Center Details

Center Code : 10916015

Verified By
Center Name : OM Computer Training Institute
Center Address : Gali No. 6, Nithari Sector 31, Noida, (Ghaziabad)
ID Proof
Educational Proof