zzz
NIRMAL DARBAR
211 Chiranjiv Tower-43, Nehru Place, New Delhi-110019
PAY-IN-SLIP No. Date: ... 2012
URN No/Form No..
CASH/DD
Axis Bank Branch, please credit: ' Nirmal Darbar ' Axis
Bank Current A/c No. 912020046933762
Name of the
Devotee
Samagam City/
Samagam
Daswand
Address
Mobile No.
Rs.
Rupees Rupees
Depositors
Signature
Received the above amount on 2012
Cashier Cashier's Scroll No.
Axis Bank
Branch Name: ____________________
Bank Copy
Denomination of Notes
DD no. & Bank Name
____________________
____________________
NIRMAL DARBAR
211 Chiranjiv Tower-43, Nehru Place, New Delhi-110019
PAY-IN-SLIP No. Date: ... 2012
URN No/Form No..
CASH/ DD
Axis Bank Branch, please credit: ' Nirmal Darbar ' Axis
Bank Current A/c No. 912020046933762
Name of the
Devotee
Samagam City
Samagam Daswand
Address
Mobile No.
Rs.
Rupees
Depositors
Signature
Received the above amount on 2012
Cashier Cashier's Scroll No.
Axis Bank
Branch Name: ____________________
Depositor Copy
Denomination of Notes
DD no. & Bank Name
____________________
____________________
NIRMAL DARBAR
211 Chiranjiv Tower-43, Nehru Place, New Delhi-110019
PAY-IN-SLIP No. Date: ... 2012
URN No/Form No..
CASH/DD
(To be sent to Nirmal Darbar by Depositor)
Axis Bank Branch, please credit: ' Nirmal Darbar ' Axis
Bank Current A/c No. 912020046933762
Name of the
Devotee
Samagam City
Samagam Daswand
Address
Mobile No..
Rs.
Rupees
Depositors
Signature
Received the above amount on 2012
Cashier Cashier's Scroll No.
Axis Bank
Branch Name: ____________________
Nirmal Darbar Copy
Denomination of Notes
DD no. & Bank Name
____________________
____________________
