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 : 151348494 Date: 07-05-2015 Chalan No / Ref No : 151348494 Date: 07-05-2015 Chalan No / Ref No : 151348494 Date: 07-05-2015 Fee Type : 58 Fee Type : 58 Fee Type : 58 Name : KAILAS RAJ R Name : KAILAS RAJ R Name : KAILAS RAJ R Date of Birth : 06/02/1997 Date of Birth : 06/02/1997 Date of Birth : 06/02/1997 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 PROCESSDEGREE 2015 - APPLICATION FEE DEGREE 2015 - APPLICATION FEE DEGREE 2015 - APPLICATION FEE

250.00 250.00 250.00

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 12-05-2015) (Please remit this chalan on or before 12-05-2015) (Please remit this chalan on or before 12-05-2015)

(Seal) (Seal) (Seal)

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