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Diploma Course

Electro Medical

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Student ID *

Student Name *

Roll Number *

Regi. Number *

DOB

Student's Email

Student's Phone *

Father's Name *

Father's Phone

Mother's Name

Mother's Phone

Permanent Address

Present Address

Present Guardian's Name

Present Guardian Phone

Academic Course *

Department *

Admission Date *

Admission Fees

Total Course Fees *

Duration(Month) *

Additional Fees

Notes

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Agreement *

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SL	Title	Amount	Remarks	Date
1	Collage Adision	7250	17/05/22--033403170522/ D--850	17/05/22 03:05 pm
2	Course Fee	10000	17/07/22--030204170722/ D--10	19/07/22 04:07 pm
3	Course Fee	50	21/09/22--049370210922/ D--8720	22/09/22 09:09 am
4	Course Fee	2000	27/11/22--069816271122/ D--7970	27/11/22 03:11 pm
5	Course Fee	4500	26/12/22--062832261222/ D--4490	26/12/22 03:12 pm
6	Course Fee	8000	23/05/23--056257230523/ D--7000	23/05/23 03:05 pm
7	Course Fee	8000	31/10/23--0111705311023/ D--9960	31/10/23 03:10 pm
8	Course Fee	10000	27/03/24--084909270324/ D--10820	27/03/24 03:03 pm
9	Course Fee	2500	29/09/24-0103434290924/ D--10920	29/09/24 03:09 pm