Excellence institute of computer science and technology

Department
(विभाग)*

Course Applied for
(पाठ्यक्रम के लिए आवेदन) *

Course Medium
(कोर्स का माध्यम)*

First Name
(पहला नाम) *

Middle Name
(मध्य नाम)

Last Name
(सरनेम)

Father's Name
(पिता का नाम) *

Mother's Name
(माता का नाम) *

Date of Birth
(जन्मतिथि)*

Mobile No.
(मोबाइल नंबर)*(To receive SMS for admission)

Email ID
(ईमेल आईडी)

Address Line 1
(स्थाई पता)*

Country
(देश)*

State
(राज्य)*

District
(जिला)*

Aadhar Enrollment No./Aadhar No.
(आधार नामांकन संख्या)*

Gender
(लिंग)*

Religion
(धर्म)*

Category
(वर्ग)*

Nationality
(राष्ट्रीयता)*

Applied For
(आवेदन)*

Passport Photo *

Signture *

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