Boc Register, Add new
Coll No
Coll Dt
September
22
2000
Amount
Status
Please select
Open
Partially Adjusted
Fully Adjusted
Shortfall
Refund Application Rcvd
Refunded
Adjusted Amt
Balance
Type
Please select
Individual
Block
Pmt By
Please select
Cash
Cheque
DD
Claim Recycle
Chq No
Bank
Acc No
Clearance
Please select
Cleared
Bounced
Proposal No
Proposal Dt
September
22
2000
Client
Medical
Yes
No
Notes
use for Multiple cases?
Please select
Single Case
Multiple Case
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