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Rent Receipt

SHANTHI LODGE
Near Old Bus Stand, Kamatchi Amman Temple
Tiruppur - 4, Ph : 04214328384
Date:

Guest Name: Room No: Bill No:


City:
Mobile / Email: Arrival Date Arrival Time:

Departure Date Departure Time:

Particulars Rate No Of Days Amount


Rs P Rs P
Room Rent
Extra Beds/Persons
Air Conditioner
Extra Charges & Services
Drinking Water

In Words
TOTAL
Regardless of the billing instruction I agree to be held personally liable for payment of the total amount of this bill.
Cashier Signature Guest Signature

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