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Diploma Course

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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

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Academic Course *

Department *

Admission Date *

Admission Fees

Total Course Fees *

Duration(Month) *

Additional Fees

Notes

Stipend *

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Agreement *

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SL	Title	Amount	Remarks	Date
1	Course Fee	1000	16/10/25--052022161025/ D--11550	18/10/25 10:10 am
2	Course Fee	2960	10/12/25--037978101225/ D--10640	10/12/25 04:12 pm