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Date : .................................. .............. Receipt No: ..................................

Student Name : .........................n v

bv...........................................................................................................

Father's Name : ...................................................................................... Room No : .......................

Accommodation Date : From .............................................. to .........................................................

Sum of (Rs)₹ : ....................................................................... Only

In Words : ........................................................................................................................................

........................................................................................................................................

Student's Signature Authorised signature

.............................................................................................................................
............................................................................................................................

Date : .................................. .............. Receipt No: ..................................

Student Name : ....................................................................................................................................

Father's Name : ...................................................................................... Room No : .......................

Accommodation Date : From .............................................. to .........................................................

Sum of (Rs)₹ : ....................................................................... Only

In Words : ........................................................................................................................................

........................................................................................................................................

Student's Signature Authorised signature