NURSING ASSISTANT (Registration)
Department of Skill Development & Employment, 360 Research Foundation
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Training Centre *
Training Provider *
Course Name *
First Payment (How much have you paid)
Batch Code *
Batch Start Date *
Batch End Date *
Student Name *
Gender *
Aadhar Number *
Date of Birth *
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/
DD
/
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Age *
Contact Number *
Address with Pin Code (Example: Kathaiya, West Champaran, Bihar-845438) *
Email *
Father's Name *
Mother's Name *
PAN Number (Not Applicable)
Highest Qualification *
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