BANK COPY PMEC COPY STUDENT COPY

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PARLA MAHARAJA ENGINEERING COLLEGE ¤ PARLA MAHARAJA ENGINEERING COLLEGE ¤ PARLA MAHARAJA ENGINEERING COLLEGE
SITALPALLI, BERHAMPUR ¤ SITALPALLI, BERHAMPUR ¤ SITALPALLI, BERHAMPUR
A/C NO: ______________________________ ¤ A/C NO: ______________________________ ¤ A/C NO: ______________________________
Sl No................ Date: ......../......./20...... ¤ Sl No................ Date: ......./......./20...... ¤ Sl No................ Date: ......./......./20......
1. Name of the Student : ________________________________ ¤ 1. Name of the Student : _________________________________ ¤ 1. Name of the Student : _______________________________
2. Admission No./Regd No. :_____________________________ ¤ 2. Admission No./Regd No. :_____________________________ ¤ 2. Admission No./Regd No. :____________________________
3. Branch : Civil/CSE/ETC/EE/Mech/Prod ¤ 3. Branch : Civil/CSE/ETC/EE/Mech/Prod ¤ 3. Branch : Civil/CSE/ETC/EE/Mech/Prod
4. Purpose : Amount ¤ 4. Purpose : Amount ¤ 4. Purpose : Amount
Rs P. ¤ Rs P. ¤ Rs P.
a- ¤ a- ¤ a-
b- ¤ b- ¤ b-
c- ¤ c- ¤ c-
d- ¤ d- ¤ d-
Total ¤ Total ¤ Total
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Cash Denominations : ¤ Cash Denominations : ¤ Cash Denominations :
Notes Rs P. ¤ Notes Rs P. ¤ Notes Rs P.
2000 x ¤ 2000 x ¤ 2000 x
500 x ¤ 500 x ¤ 500 x
200 x 200 x 200 x
100 x ¤ 100 x ¤ 100 x
50 x ¤ 50 x ¤ 50 x
20 x ¤ 20 x ¤ 20 x
10 x ¤ 10 x ¤ 10 x
5 x ¤ 5 x ¤ 5 x
2 x ¤ 2 x ¤ 2 x
1 x ¤ 1 x ¤ 1 x
Total ¤ Total ¤ Total
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DD/PO/Banker's Cheque ¤ DD/PO/Banker's Cheque ¤ DD/PO/Banker's Cheque
DD No. Date Name of the Bank Place Rs. P. ¤ DD No. Date Name of the Bank Place Rs. P. ¤ DD No. Date Name of the Bank Place Rs. P.
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Amount in Words ....................................................................................... ¤ Amount in Words ....................................................................................... ¤ Amount in Words ......................................................................
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............................ ............................ ........................... ¤ ................................ ............................ ........................... ¤ ................................ ............................ ...........................
Depositor's Signature Cashier Signature Officer Signature ¤ Depositor's Signature Cashier Signature Officer Signature ¤ Depositor's Signature Cashier Signature Officer Signature
Mobile No: ................................... ¤ Mobile No: ................................... ¤ Mobile No: ...................................
* Mention Student Name & Registration No in narration