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ssnan0%7 ‘Alen Career Insie, Kota - Application Ferm Detals. Corporate Offic = LEN “SANKALP", CP-6, Indra Vihar, Kota, (Rajasthan) - 324005, (CAREER, Te Ph.: +91-744-5162200 Website: dio.allen.acin | E-mail: dlo@allen,acin tance Learning Programme (Session 2016-17) Test Series Identity Card No “eplcaton Form | 16402895 AANA AA) hot sranh Student's Name: KRUSHNA DATTA BEHERA Father's Name: BATAKRUSHNA BEHERA Mothers Name: SOVA BEHERA ender: MALE Medium: | ENGLISH stream: PRE-MEDICAL IUSHIADATINSEHERA ‘Course Name / Course Code: | MAJOR TEST SERIES FOR NEET-UG/6101 Batch/Reg No: MLM1714 Test Conter: KOTAINDRA VIHAR Tost Contor Address: | ALLEN SAVINAY (MILLENIUM TOWER) CP-1, INDRA VIHAR Please Put Your Signature in the space provided for Student signature «Without -Card you wll at be allowed to appear in antes + Tosppear in tests mandatory fr stunt to carry any poto ID along with tis Kent card {To cece our result with cetaledsraysispease vist dsat.allen cin 5 You can cll at our dedicated helpline +91-744-5162200 for assistance between 10:00 AM to 07:00 PM Date: Student's Signature ip dlp allen inp 6 17/PrireadmitCardaspx w

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