{var-PAGEHEADING}

{var-cartInfo}

SUPPLIER BANKERS

Account Name:

Bank Name     :

Account Type  : Current Account

Account No.    :

IFSC Code       :


{err-myform}
Fill Payment Details
{lbl-payment_mode}
{err-payment_mode}		 {fld-payment_mode}
{lbl-payment_ref_no}
{err-payment_ref_no}		 {fld-payment_ref_no}
{lbl-payment_ref_date}
{err-payment_ref_date}		 {fld-payment_ref_date}
{lbl-payment_ref_bank}
{err-payment_ref_bank}		 {fld-payment_ref_bank}
{lbl-payment_ref_branch}
{err-payment_ref_branch}		 {fld-payment_ref_branch}
{lbl-payment_ref_amount}
{err-payment_ref_amount}		 {fld-payment_ref_amount}
{fld-sb}