12/22/2015 Aipmt 2016

Central Board of Secondary Education Central Board of Secondary Education
(Candidate Copy) (Bank Copy)

HDFC Bank HDFC Bank

AIPMT - 2016 AIPMT - 2016

Challan Form for Online Payment Challan Form for Online Payment

Cash can be tendered at any CBS Branch of Bank Cash can be tendered at any CBS Branch of Bank

Fees: Rs.  1400/­ Only   Fees: Rs.  1400/­ Only  
This Form is valid for online application registered between 15.12.2015 to 08.01.2016 to deposit fee in the Bank .
This Form is valid for online application registered between 15.12.2015 to 08.01.2016 to deposit fee in the Bank .
HDFC Bank A/C: AIPMT (50100073338160)
HDFC Bank A/C: AIPMT (50100073338160)
Registration No. : 7008249 (Provisional till successful transaction of fee)
Registration No. : 7008249 (Provisional till successful transaction of fee)
Name : TANUJ HANDA
Name : TANUJ HANDA
Date of Birth : 18/11/1998
Date of Birth : 18/11/1998
Father's Name: NAVNEET HANDA
Father's Name: NAVNEET HANDA
Category : UR
Category : UR
 
Signature of the Candidate/ Signature of the Candidate/
Signature of the Depositor _________________________________ Signature of the Depositor _________________________________

To be filled by the bank To be filled by the bank

HDFC Bank Branch Name: ___________________________ HDFC Bank Branch Name: ___________________________

Branch Code: ___________________________ Branch Code: ___________________________

Transaction ID: ___________________________ Transaction ID: ___________________________

Deposit Date: _____/______/______ Deposit Date: _____/______/______

  Authorized Signatory   Authorized Signatory

Branch Stamp Branch Stamp

Application Registered on : 18/12/2015 Application Registered on : 18/12/2015

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