STATE BANK OF TRAVANCORE STATE BANK OF TRAVANCORE STATE BANK OF TRAVANCORE

(ORIGINAL - Remitter's Copy) (DUPLICATE - To The Calicut University Office) (TRIPLICATE - To be retained by the Bank)
Chalan No / Ref No : 141056621 Date: 21-05-2014 Chalan No / Ref No : 141056621 Date: 21-05-2014 Chalan No / Ref No : 141056621 Date: 21-05-2014
Fee Type : 58 Fee Type : 58 Fee Type : 58
Name : SHAHANA T Name : SHAHANA T Name : SHAHANA T
Date of Birth : 18/04/1994 Date of Birth : 18/04/1994 Date of Birth : 18/04/1994
SBT Screen No : 8888 SBT Screen No : 8888 SBT Screen No : 8888
Purpose of Remittance Amount Purpose of Remittance Amount Purpose of Remittance Amount
CENTRALIZED ADMISSION PROCESS CENTRALIZED ADMISSION PROCESS CENTRALIZED ADMISSION PROCESS
DEGREE 2014 - APPLICATION FEE DEGREE 2014 - APPLICATION FEE DEGREE 2014 - APPLICATION FEE
100.00 100.00 100.00
Service charge for SBT as applicable Service charge for SBT as applicable Service charge for SBT as applicable
Total Amount Total Amount Total Amount
Signature of Remitter Signature of Remitter Signature of Remitter
Signature of Cashier Signature of Manager Signature of Cashier Signature of Manager Signature of Cashier Signature of Manager
(Please remit this chalan on or before 03-06-2014) (Please remit this chalan on or before 03-06-2014) (Please remit this chalan on or before 03-06-2014)
(Seal) (Seal) (Seal)
1 4 1 0 5 6 6 2 1 1 4 1 0 5 6 6 2 1 1 4 1 0 5 6 6 2 1