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College Copy

Jai Narain Vyas University, Jodhpur


Examination Form - (2021 - 2022)
Online Payment Challan

Submitted Date:12/01/2022 11:56:38 Correction Date :--NA-- Print Date & Time :12/01/2022 11:58:28

Form No. : 11151793

Name : RISHITA REEL

Father's Name : RAJU REEL

Mother's Name : SAROJ REEL

Degree : B.C.A. Ist Year

Subject : Computer Application

Category : REGULAR

Paid Amount : 1205.00

Transaction ID / Demand Draft No. : EF_0001711904

Payment Date : 12/01/2022 11:56:38

Payment Due Date :

Mobile No. : 8107985118

I RISHITA REEL hereby declare that I have made online payment for the online Examination fees, for which
details are mentioned above. If at any point of time it is found that the receipt is fake or amount is not credited in
University Account my Examination form will be rejected.

Date : 12/01/2022 Signature


Note : कृपया E-Payment रसीद की दो कॉपियां print कर एक कॉपी form के साथ सम्बंधित
फैकल्टी में जमा करवाएं एवं दूसरी कॉपी अपने पास रखें।
Student Copy
Jai Narain Vyas University, Jodhpur
Examination Form - (2021 - 2022)
Online Payment Challan

Submitted Date:12/01/2022 11:56:38 Correction Date :--NA-- Print Date & Time :12/01/2022 11:58:28

Form No. : 11151793

Name : RISHITA REEL

Father's Name : RAJU REEL

Mother's Name : SAROJ REEL

Degree : B.C.A. Ist Year

Subject : Computer Application

Category : REGULAR

Paid Amount : 1205.00

Transaction ID / Demand Draft No. : EF_0001711904

Payment Date : 12/01/2022 11:56:38

Payment Due Date :

Mobile No. : 8107985118

I RISHITA REEL hereby declare that I have made online payment for the online Examination fees, for which
details are mentioned above. If at any point of time it is found that the receipt is fake or amount is not credited in
University Account my Examination form will be rejected.

Date : 12/01/2022 Signature


Note : कृपया E-Payment रसीद की दो कॉपियां print कर एक कॉपी form के साथ सम्बंधित
फैकल्टी में जमा करवाएं एवं दूसरी कॉपी अपने पास रखें।

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