TIN No. 09221803142 \ INDRA TIN No.

09221803142 \ INDRA
C.S.T. No. Fz. 5012962 & 236140, 236098 C.S.T. No. Fz. 5012962 & 236140, 236098
BRICK FIELD BRICK FIELD
A.M. / P.M. A.M. / P.M.
CHALLAN CHALLAN

B.D.S. BRICKS B.D.S. BRICKS

BANBIRPUR, FAIZABAD BANBIRPUR, FAIZABAD
No. Date .................... No. Date ....................
Name ....................................................... Name .......................................................

........................................Ph. ................... ........................................Ph. ...................

No. of Bricks ...................... Rs. ............... No. of Bricks ...................... Rs. ...............

................................................................. .................................................................

Sign. of Customer .................... Sign. of Customer ....................

Signature Signature
d`i;k bZaVksa dh fxurh dj ysaA d`i;k bZaVksa dh fxurh dj ysaA

d`i;k bZaVksa dh fxurh dj ysaA d`i;k bZaVksa dh fxurh dj ysaA

Signature Signature

Sign. of Customer .................... Sign. of Customer ....................

................................................................. .................................................................

No. of Bricks ...................... Rs. ............... No. of Bricks ...................... Rs. ...............

........................................Ph. ................... ........................................Ph. ...................

Name ....................................................... Name .......................................................

Date .................... No. Date .................... No.

BANBIRPUR, FAIZABAD BANBIRPUR, FAIZABAD
B.D.S. BRICKS B.D.S. BRICKS
CHALLAN CHALLAN
P.M. A.M. / P.M. A.M. /
BRICK FIELD BRICK FIELD
& 236140, 236098 C.S.T. No. Fz. 5012962 & 236140, 236098 C.S.T. No. Fz. 5012962
INDRA \ TIN No. 09221803142 INDRA \ TIN No. 09221803142