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Study Centre Code
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Name of the Owner
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Permanent Address of Study Centre
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Available Covered Area / Total Room
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Details of the Authorized person of institute who work with our Organization on the behalf of the institute
Name
Father Name
Mother Name
Date Of Birth :
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LAXMI NIWAS,NEAR A.T.GATE, BUTCHERY GROUND,POST-CIVIL AERODROME, P.S-MAGADH MEDICAL, DIST-GAYA (BIHAR)823004.
Details of Staff: (with designation & Mobile No.)
First
Mobile Number
Second
Mobile Number
Details of Fee for establishing the centre
Amount In Rs
Amount In words
Name of the Bank
