নীল কোম্পানি লোগো

BIN:
MONEY RECEIPT
MUSHAK: 6.3
Issuing Office   :  
Money Receipt No  :  
Class of Insurance  :  
Date  :  
Received with thanks from:
The sum of:
Tk. ()
Mode of Payment:
Dated 
Drawn on:
Issued against:
PremiumBDT
StampBDT
TotalBDT
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This RECEIPT is computer generated, authorized signature is not required.
Receipt valid subject to encashment of cheque/P.O./D.D.