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General
S. & E. (11/74)
(Internet Version)

ºåɨåÈè¨ ÉÉê®ÇÆ
TEMPORARY VOUCHER
ÄêÈà ÉÉê®Ç ¡â¨Æ ...................................................
Original Voucher No.

Ìà»å¾Æ/Station : ...........................................................................................................................

ÊûÚË ¡â¨Æ/Head No. ..............................................................................................................

̊ĺ ÉæÆ Äê¼Èà ¡â¨Æ/ Vote No. .........................................................................................

¡â¨Æ/No. ..........................................................................

¤À ÊûÚËÆ
—ÌàºÇÆ/Description ...............................................................................................................................................
Sub-head
......................................................................................................................................................................................................

Äê¼È/ Amount : Çæ./Rs. ................................................................................. Ê./c. .................................

ïªÑŠ ÌàÉÃåÉÆ/ Nature of Payment :–

Ìͺø¨ ¨Ç¾ ¾øȽåÖÆåïªà ¾Ä ÌÍ À¼—Æ .................................................................................................................................

Name and Designation of certifying officer

...............................................................................................................................................................................................................................................................

ÄêÈà ÉÉê®ÇÆ ¡åÀÌê ªæ¾ùïŠ ïÍàºëÉ ÌÍ ¦Æ ¢¼úÖÀºà ¨Ç¾ê Ⱦ ¼ú¾Æ .................................................................................
Reason for withdrawal of Original Voucher indicating when it will be furnished

...............................................................................................................................................................................................................................................................

...............................................................................................................................................................................................................................................................

...............................................................................................................................................................................................................................................................

¡ºà̾/Signature : ........................................................................................

¼ú¾Æ/Date : ............................................ À¼—Æ/Designation : .....................................................................................

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