Original Copy

Bill of Supply cum Receipt

LFS Healthcare Pvt. Ltd

3rd Floor, Parsvnath Arcadia, Sector-14, Gurgaon - 122001

https://dash.droplet.net.in

care@droplet.net.in

GSTIN: 06AACCL9649R1ZL
Date: 23-06-2019
Serial no. of Invoice: LT19200600553685

Details of Receiver (Billed to) Details of Consignee (Shipped to)

Name: Ramendra Kumar srivastava Name: Ramendra Kumar srivastava

Address: H.No.Q1 7 southcity 2 sector 49, Park hospital, Address: H.No.Q1 7 southcity 2 sector 49, Park hospital,
Gurgaon, 122018 Gurgaon, 122018

State: State:

State Code: State Code:

GSTIN/Unique ID: GSTIN/Unique ID:

S. No. Description of Services HSN/SAC Code Taxable value

1. Glucose - Fasting Blood 999316 60.0
2. Good health package 599.0
Invoice Total (In words): Six hundred and fifty-nine Total 659.0

For LFS Healthcare Private Limited

Terms & Conditions

1. Interest 18% p.a. will be charged if the payment is not made

with in the stipulated time.
2. All disputes will be subject to Gurugram Jurisdiction only

CIN: U85100HR2015PTC057368

PAN: AACCL9649R

Authorised Signatory