Customer Copy
MRINAL CREATIONS
Your Trusted Partner in Digital Growth.
📍 Faridpur, Dakshin Dauki, Purba Medinipur, W.B - 721450
📞 03220-284 505 | 📱 +91 96359 29353 | ✉️ care@mrinalcreations.com
Registered Trademark & ISO 9001 : 2015 Certified
TRANSACTION & DENOMINATION LOG
Customer & Payment Metadata
Transaction Date
Transaction / Ref ID
Customer Name
Mobile Number
Customer Address
Transaction Type
AePS (Aadhaar Enabled Payment)
PhonePe
Google Pay (GPay)
QR Code Scan
Others / Cash Exchange
Verification Token (Last 4 Digits)
Routing / Processing Bank Name
-- Select Bank Name --
State Bank of India (SBI)
Punjab National Bank (PNB)
Bank of Baroda (BoB)
Bank of India (BoI)
Canara Bank
Central Bank of India
Indian Bank
Union Bank of India
HDFC Bank Ltd
ICICI Bank Ltd
Axis Bank Ltd
Bandhan Bank
UCO Bank
Airtel Payments Bank
India Post Payments Bank (IPPB)
Fino Payments Bank
Bangiya Gramin Vikash Bank (BGVB)
Paschim Banga Gramin Bank
Cash Denomination Breakdown
₹ 500
×
₹ 0
₹ 200
×
₹ 0
₹ 100
×
₹ 0
₹ 50
×
₹ 0
₹ 20
×
₹ 0
₹ 10
×
₹ 0
₹ 5
×
₹ 0
₹ 2
×
₹ 0
₹ 1
×
₹ 0
Grand Total:
₹ 0
Zero Rupees Only
Verification & Authorization
Customer Signature / Thumb Impression
Clear Signature
Office Copy
MRINAL CREATIONS
Your Trusted Partner in Digital Growth.
📍 Faridpur, Dakshin Dauki, Purba Medinipur, W.B - 721450
📞 03220-284 505 | 📱 +91 96359 29353 | ✉️ care@mrinalcreations.com
Registered Trademark & ISO 9001 : 2015 Certified
TRANSACTION & DENOMINATION LOG
Customer & Payment Metadata
Transaction Date
Transaction / Ref ID
Customer Name
Mobile Number
Customer Address
Transaction Type
AePS (Aadhaar Enabled Payment)
PhonePe
Google Pay (GPay)
QR Code Scan
Others / Cash Exchange
Verification Token (Last 4 Digits)
Routing / Processing Bank Name
-- Select Bank Name --
State Bank of India (SBI)
Punjab National Bank (PNB)
Bank of Baroda (BoB)
Bank of India (BoI)
Canara Bank
Central Bank of India
Indian Bank
Union Bank of India
HDFC Bank Ltd
ICICI Bank Ltd
Axis Bank Ltd
Bandhan Bank
UCO Bank
Airtel Payments Bank
India Post Payments Bank (IPPB)
Fino Payments Bank
Bangiya Gramin Vikash Bank (BGVB)
Paschim Banga Gramin Bank
Cash Denomination Breakdown
₹ 500
×
₹ 0
₹ 200
×
₹ 0
₹ 100
×
₹ 0
₹ 50
×
₹ 0
₹ 20
×
₹ 0
₹ 10
×
₹ 0
₹ 5
×
₹ 0
₹ 2
×
₹ 0
₹ 1
×
₹ 0
Grand Total:
₹ 0
Zero Rupees Only
Verification & Authorization
Authorized Representative Signature
Clear Signature
Reset Fields
Submit & Save Data
Print A4 Landscape Copies
✔ Data System: Entries Processed & Saved Successfully