Received with thanks from Sh.....................................................
S/D Of Sh.....................................................................................
On account of following dues :1. Tution Fees
Rs.................................
2. Development Charges
Rs.................................
3. Students Fund
Rs.................................
4. ...................................
Rs.................................
5. ...................................
Rs.................................
6. ...................................
Rs.................................
7. ...................................
Rs.................................
8. ...................................
Rs.................................
Total Rs.
The sum of Rs...............................................................................
......................................................................................................
By cash/cheque no. .....................................................................
Drawn on Bank ............................................................................
On account of ..............................................................................
Signature Payee
Signature Recipient & Stamp
Provisional Collection Subject to Eligibility as per University Norms