ORIGINAL - Concerned Department DUPLICATE - Applicant

Branch: Sunset Boulevard Branch, Karachi (1620) Account #: 277409209 Branch: Sunset Boulevard Branch, Karachi (1620) Account #: 277409209

College of Physicians and Surgeons Pakistan College of Physicians and Surgeons Pakistan

Cash Deposit Fellow (Bank Challan) Cash Deposit Fellow (Bank Challan)
Fee can be paid in any UBL branch in Pakistan Fee can be paid in any UBL branch in Pakistan

Center: Lahore CPSP ID: 2018-1369 Center: Lahore CPSP ID: 2018-1369

Receipt #: LHR-C-22-33031 Receipt Date: 23-07-2022 Receipt #: LHR-C-22-33031 Receipt Date: 23-07-2022

Name: SUNDAS QAYYUM Name: SUNDAS QAYYUM

Form No: 2022-13537 Form No: 2022-13537

Fee Type Amount Fee Type Amount

IMM Certificate PKR 5500.00 IMM Certificate PKR 5500.00

IMM Certificate Late Fee PKR 1000.00 IMM Certificate Late Fee PKR 1000.00

Total: PKR 6500.00 Total: PKR 6500.00

Amount in words: Six Thousand Five Hundred Only (PKR) Amount in words: Six Thousand Five Hundred Only (PKR)

____________________________ ____________________________ ____________________________ ____________________________

Candidate / Depositor Signature Receiver's Signature Candidate / Depositor Signature Receiver's Signature

Contact No: ________________ Contact No: ________________

Note: Depositer/candidate must ensure that bank stamp is readable and signed. Note: Depositer/candidate must ensure that bank stamp is readable and signed.

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 TRIPLICATE - CPSP Finance QUADRUPLICATE - Bank

Branch: Sunset Boulevard Branch, Karachi (1620) Account #: 277409209 Branch: Sunset Boulevard Branch, Karachi (1620) Account #: 277409209

College of Physicians and Surgeons Pakistan College of Physicians and Surgeons Pakistan

Cash Deposit Fellow (Bank Challan) Cash Deposit Fellow (Bank Challan)
Fee can be paid in any UBL branch in Pakistan Fee can be paid in any UBL branch in Pakistan

Center: Lahore CPSP ID: 2018-1369 Center: Lahore CPSP ID: 2018-1369

Receipt #: LHR-C-22-33031 Receipt Date: 23-07-2022 Receipt #: LHR-C-22-33031 Receipt Date: 23-07-2022

Name: SUNDAS QAYYUM Name: SUNDAS QAYYUM

Form No: 2022-13537 Form No: 2022-13537

Fee Type Amount Fee Type Amount

IMM Certificate PKR 5500.00 IMM Certificate PKR 5500.00

IMM Certificate Late Fee PKR 1000.00 IMM Certificate Late Fee PKR 1000.00

Total: PKR 6500.00 Total: PKR 6500.00

Amount in words: Six Thousand Five Hundred Only (PKR) Amount in words: Six Thousand Five Hundred Only (PKR)

____________________________ ____________________________ ____________________________ ____________________________

Candidate / Depositor Signature Receiver's Signature Candidate / Depositor Signature Receiver's Signature

Contact No: ________________ Contact No: ________________

Note: Depositer/candidate must ensure that bank stamp is readable and signed. Note: Depositer/candidate must ensure that bank stamp is readable and signed.

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