(See Note 1 below rule 34)
| Bill No. & Date | Particulars of Bill | Net amount of Bill | Dated initials of Gazetted Officer signing Bill | Date of presentation at/ despatch to Pay & Accounts Office/ Cheque drawing DDO | Token No./ Post Office Registered receipt No. | Amount passed by PAO/ Cheque drawing D.D.O. | Date of signing acknowledgement | No. and Date of 1 Voucher | No. and Date of cheque or Bank Draft |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Rs. P.
|
Date of entry in Cash Book/ Open cheque Acquittance roll/ crossed cheque transit register as the case may be |
Initial of Gazetted Officer in charge of Cash |
Amount Disbursed in |
No. and Date of Bill in which balance short drawn | Remarks | ||
| Month of encashment | 2nd Month | 3rd Month | ||||
| 11 | 12 | 13 | 14 | 15 | 16 | 17 |
| Rs. P.
|
Rs. P.
|
Rs. P.
|
||||