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PAYMENT
| COURSE TITLE | AMOUNT (RS.) |
|---|---|
|
(Click on the Title to see Course details.) | 2000.00 |
| TOTAL (Rupees Two Thousand only) | 2000.00 |
| Mr. Ms. (Radio Buttons for selection of Title) | First Name | Last Name |
| Email ID | Mobile Number | Date of Birth |
| Address | City/Village | District |
| State | PIN |