| 01. Course Applied for |
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| 02. Personal Details |
| Candidate's Name : |
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| Father's Name : |
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| Mother's Name : |
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| Father's Occupation : |
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| Annual Income (Rs.) : |
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| DOB : |
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| Gender : |
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| E-Mail ID : |
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| Aadhaar No. : |
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| Nationality : |
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| Permanent Address : |
Correspondance Address : |
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| Category1 |
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| Category2 |
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| Religion |
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| Candidate's Mobile No. |
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| Parent's Mobile No. |
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| Payment Mode |
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| Challan/Transctaion ID |
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| Amount |
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| User ID |
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| Signature of Candidate |
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