Place _______________
Date _______________
Rs.__________________
__________(No. of days) after date, pay to Sh. ___________________________ or Sh. ______________________ or Sh._________________________________ or the order of any of them the sum of Rs. _________________ (Rupees _______________________________________ only) with interest at ___________ per cent per annum.
Drawer (Name)
Stamp
To,
Drawee (Name)
__________ (Address)
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