Name of By whom

Candidate: tendered

Name /
designation &
Directorate of Central Health
T.R-6

Establishment, Islamabad
Address on

Payment Received
(Treasury Rule 29)

whose behalf
money is paid
Challan of cash paid in to the

(Rupees one hundred only)

Particulars of
remitter

FMEDICAL EXAMINATION FEE the remittance

& Authority
To be filled in by the

Rs. 100/- Amount

Challan No.

State Bank of Pakistan

C – 02839- HEALTH fee for medical

Treasury/Sub-Treasury

Head of Accounts
CEN TRAL

examination
National Bank of Pakistan

Treasurer/Accountant/Treasury Officer
or the Treasury

(Signature & Stamp of Officer ordering the

TRIPLICATE

To be filled in by the
Departmental Officer

money to be paid in)

Order of the Bank*

Name of By whom
Candidate: tendered

Name /
designation &
T.R-6

Directorate of Central Health

Address on
Establishment, Islamabad
(Treasury Rule 29)

Payment Received

whose behalf
money is paid
Challan of cash paid in to the

remitter

(Rupees one hundred only)

Particulars of
FMEDICAL EXAMINATION FEE the remittance
& Authority
To be filled in by the

Rs. 100/- Amount

C – 02839- HEALTH fee for medical

Challan No.

examination
Head of Accounts
State Bank of Pakistan
Treasury/Sub-Treasury
CENTRAL

National Bank of Pakistan

Treasurer/Accountant/Treasury Officer
or the Treasury

(Signature & Stamp of Officer ordering the

To be filled in by the
Departmental Officer
DUPLICATE

money to be paid in)

Order of the Bank*

Name of By whom
Candidate: tendered

Name /
T.R-6

designation &
Directorate of Central Health
(Treasury Rule 29)

Establishment, Islamabad
Address on
Payment Received

whose behalf
Challan of cash paid in to the

money is paid
remitter

(Rupees one hundred only)

Particulars of
FMEDICAL EXAMINATION FEE the remittance
& Authority
To be filled in by the

Rs. 100/- Amount

Challan No.

C – 02839- HEALTH fee for medical

State Bank of Pakistan

Head of Accounts
Treasury/Sub-Treasury
CENTRAL

examination
National Bank of Pakistan

Treasurer/Accountant/Treasury Officer
or the Treasury

(Signature & Stamp of Officer ordering the

ORIGINAL
(CMB COPY)

To be filled in by the
Departmental Officer

money to be paid in)

Order of the Bank*