Rupees  Only<br/><br/>

<table width="100%" border="1" cellspacing="0" cellpadding="0">
  <tr>
    <td colspan="4"><strong>Payment Mode:</strong></td>
  </tr>
  <tr>
     
     <th>Mode</th>
     <th>Amount</th>              
    <th>Total BV</th> 
 </tr>
   <tr>
     
     <th></th>
     <th>0</th>
     <th></th>
  </tr>

</table>