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College Copy

Jai Narain Vyas University, Jodhpur


Examination Form - (2019 - 2020)
Online Payment Challan

Submitted Date:13/01/2020 13:50:22 Correction Date :--NA-- Print Date & Time :13/01/2020 13:57:24

Form No. : 10741513

Name : POOJA GURJAR

Father's Name : MADAN LAL GURJAR

Mother's Name : RAJBALA GURJAR

Degree : B.A IInd Year

Subject : Home Science, Geography, English Lit.

Category : REGULAR

Paid Amount : 1225.00

Transaction ID / Demand Draft No. : EF_0001133903

Payment Date : 13/01/2020 13:50:22

Payment Due Date : 15/01/2020 23:59:59

Mobile No. : 8278655202

I POOJA GURJAR 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 : 13/01/2020 Signature


Note : कृपया E-Payment रसीद की दो कॉपियां print कर एक कॉपी form के साथ सम्बंधित
फैकल्टी में जमा करवाएं एवं दूसरी कॉपी अपने पास रखें।
Student Copy
Jai Narain Vyas University, Jodhpur
Examination Form - (2019 - 2020)
Online Payment Challan

Submitted Date:13/01/2020 13:50:22 Correction Date :--NA-- Print Date & Time :13/01/2020 13:57:24

Form No. : 10741513

Name : POOJA GURJAR

Father's Name : MADAN LAL GURJAR

Mother's Name : RAJBALA GURJAR

Degree : B.A IInd Year

Subject : Home Science, Geography, English Lit.

Category : REGULAR

Paid Amount : 1225.00

Transaction ID / Demand Draft No. : EF_0001133903

Payment Date : 13/01/2020 13:50:22

Payment Due Date : 15/01/2020 23:59:59

Mobile No. : 8278655202

I POOJA GURJAR 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 : 13/01/2020 Signature


Note : कृपया E-Payment रसीद की दो कॉपियां print कर एक कॉपी form के साथ सम्बंधित
फैकल्टी में जमा करवाएं एवं दूसरी कॉपी अपने पास रखें।

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