INVOICE

INVOICE No: AHEL/ ARI-CHE/009 DATE: 2-Dec-15

Apollo Hospitals Enterprise Limited

Site Address Receiver Ref: Other Recerence(s)

Flat No.1/16 & 1/17, II floor, Krishnadeep Chambers(Apollo Annexe)

#1 Wallace Garden, Thousand Lights, Chennai 600 006

Protocol No:

Invoice to: Sponsor

Trial Name : Prose

Sponsor Name : I process Clinical research marketing

Address: P I Name : Dr. Abraham Oomman
I process Clinical research marketing
Bangalore

Amount (INR)
Sr. No. Description of Service

1 Randomization payment for 16 patients 16,900

SUB TOTAL 16,900

Servive Tax ( 14.5%) 2,451

TOTAL 19,351
Amount Chargeable (In words)
E & O.E
( Ninetten thousand three hundred and fifty one only)
Company Service Tax No: AAACA5443NSD005 Bank Name ICICI Bank

Category : Technical Service Account No 000905026065

PAN AAACA5443N IFSC / RTGS Code ICIC0000009

Note: Interest @24% p.a will be charged on bills due date beyond 30 days
for Apollo Hospitals Enterprise Limited

Authorised Signatory