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Receipt for site/laboratory Work

Received an amount of Rs.. (Rupees)

from Dr./Shri.. towards the labour charge for the fallowing work done

at site/laboratory during the period .to (. Days) @ Rs.

Per day.

Sl. No. Date Name of work Detail of work

site

Certified that the above work done Signature of Claimant.


in my presence and payment made Name:..
by for above work. Address:
..
..
Signature of PI/Supervisor:
Name:
Deptt.:

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