Puja Tour & Travels

Address: Goura, P.O. Secondary, Paschim Medinipur, West Bengal. 721146

Mob: 7008822463, 8777508281

Date: _______________________

Receipt #: ___________________

Rental Company Info:

Address: _____________________
Company: ________________________
Phone: _______________________
Representative: ____________________

Vehicle Information:
V/N: _______________________ Date: _______________________

From: ______________________ To: ________________________

Starting KM Ending KM Cost/Day # of Days Additional Costs Line Total

Payment Method: Subtotal:

☐ Cash. ☐ Check. No: _______________ Tax ( %):

☐ Credit. No: _______________ Total:

☐ Other. _______________ Amount Paid:

Rupees: _________________________ Authorized Signature: _______________________

_________________________________ Representative Name: _______________________

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