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Amount of the bill

Amount disbursed in

Detailed heads of account, etc.

Bill number and date

Particulars of the bill

Pay of Establishment

Dearness allowance

Compensatory allowance

House rent and other allowances

Travelling allowance

Gross amount

Deductions

Net amount

Dated initials of the officer signing the bill.

Date of presentation at the Treasury

Amount passed by the Treasury

Date of signing payee’s discharge to the Bank in case of Banking Treasury with initials of the officer signing the bill

Date of receipt from the Treasury

Date of entry in the cash-book

Initials of the officer-in-charge of the cash

Month of encashment

2nd month

3rd month

Reference to number and date of bill in which balance has been short drawn

Remarks