petty cash

Take a copy of the ledger page showing balance of the cash to which verification has been done with the signature of the cashier and the signature of auditor with time and date. There is no specific format for it. Just on a simple paper put down the denominations and signed the same as mentioned above 

thank you

As said by Anuj, take the petty cash ledger copy for the respective month reflecting the closing balance and write the denominations found and report if any differences found. If you want any format make by urself view the attachment and get the signature of the person who maintains petty cash ledger...