Submit Date: 08/09/2021 Print Date: 9/8/2021 10:23:38 PM

Gauhati University
Examination Form Payment Receipt - For College

Examination Form Receipt Form No : 10003701591

Student Name JYOTIRMOY CHOUDHURY Registration No 20004474

Father's Name NRIPEN CHOUDHURY Mother's Name JNANADA DAS CHOUDHURY

Mobile 8638259573 Student Category Traditional

Degree B.Sc (Hons) CBCS IInd Sem

College Name 012 | DAKSHIN KAMRUP COLLEGE

Transaction ID / Demand Draft No. EF_210908222027_1032254 Payment Date 08/09/2021 22:20:27

Paid Amount 680.00

I JYOTIRMOY CHOUDHURY hereby declare that I have made online payment for the online Examination fees, for
which details are mentioned above. If at any point of time it is found that the receipt is fake or amount is not
credited in University Account my Examination form will be rejected.

Date : 9/8/2021 Student Signature

Student Signature

Note : Please submit the E-Payment receipt's office copy to the single window in central office and keep the student copy with
yourself
Submit Date: 08/09/2021 Print Date: 9/8/2021 10:23:38 PM

Gauhati University
Examination Form Payment Receipt - For Student

Examination Form Receipt Form No : 10003701591

Student Name JYOTIRMOY CHOUDHURY Registration No 20004474

Father's Name NRIPEN CHOUDHURY Mother's Name JNANADA DAS CHOUDHURY

Mobile 8638259573 Student Category Traditional

Degree B.Sc (Hons) CBCS IInd Sem

College Name 012 | DAKSHIN KAMRUP COLLEGE

Transaction ID / Demand Draft No. EF_210908222027_1032254 Payment Date 08/09/2021 22:20:27

Paid Amount 680.00

I JYOTIRMOY CHOUDHURY hereby declare that I have made online payment for the online Examination fees, for
which details are mentioned above. If at any point of time it is found that the receipt is fake or amount is not
credited in University Account my Examination form will be rejected.

Date : 9/8/2021 Student Signature

Student Signature

Note : Please submit the E-Payment receipt's office copy to the single window in central office and keep the student copy with
yourself