1. Employees' State Insurance Corporation
CHALLAN FOR FEE PAYMENT
BY CASH ONLY
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Employees' State Insurance Corporation
CHALLAN FOR FEE PAYMENT
BY CASH ONLY
BANK COPY
(To be retained by SBI Branch)
DEPOSIT IN ANY BRANCH OF
STATE BANK OF INDIA
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CANDIDATE'S COPY
(To be retained by Candidate)
DEPOSIT IN ANY BRANCH OF
STATE BANK OF INDIA
Fee can be deposited after minimum 24 hours of generation of challan on any
bank working day
| Fee can be deposited after minimum 24 hours of generation of challan on any
bank working day
Challan Generation Date 03-Nov-2014 | Challan Generation Date 03-Nov-2014
SBI CBS Screen Number
8888
Fee Type
265
| SBI CBS Screen Number
8888
Fee Type
265
Bank Reference No. : 10001873 | Bank Reference No. : 10001873
Date of Birth : 01-Mar-1987 | Date of Birth : 01-Mar-1987
Name of Candidate : VINEET KUMAR DUBEY | Name of Candidate : VINEET KUMAR DUBEY
Post Applied : Dental Surgeon | Post Applied : Dental Surgeon
Mobile No. : 9701532694 | Mobile No. : 9701532694
AMOUNT (IN FIGURES)
(Fee including of Bank charges)
Rs.300 /-
AMOUNT (In WORDS): Rupees Three
Hundred Only
Denominations
1000 x
500 X
100 X
50 X
20 x
10 X
5 X
2 X
1 X
TOTAL 300 /-
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AMOUNT (IN FIGURES)
(Fee including of Bank charges)
Rs.300 /-
AMOUNT (In WORDS): Rupees Three
Hundred Only
Denominations
1000 x
500 X
100 X
50 X
20 x
10 X
5 X
2 X
1 X
TOTAL 300 /-
Signature of Depositor : | Signature of Depositor :
Details below to be filled-in by the Bank | Details below to be filled-in by the Bank
SBI Journal No. Date Of Receipt |
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SBI Journal No. Date Of Receipt
Branch Code
Signature of Bank’s Official
with Seal
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Branch Code
Signature of Bank’s Official
with Seal