Tax Invoice Invoice Number: AHM12/19/13542

Original for Receipt

Keep the original invoice and barcode on medicines intact for returns

Sold By (Pharmacy) Bill To / Ship To (Patient)

Jadhav Chemist Order Id: 8736430
Pritam Jana
Shop No 18 F Shagun casa , Opp Vraj Vihar tower, 2019-05-02
Jodhpur char rasta, Ahmedabad-380015
Order Date: Flat 202, Shyam Villa, Vasabeera
Society, Near Samarpan Circle, ,
Invoice Date: 2019-05-02 Jamnagar, Gujarat, 361006
DL Number 20-GJ-AD2-151222(2023-01-31), 21-GJ-AD2-151223(2023-01-
Doctor Name Dr. DINKAR
31),
SAVARIYA
GSTIN 24AANFJ4669H1ZZ POS : 24-GUJARAT

S No Description of Goods MFR/MKT HSN Code Qty Batch No Exp Date MRP Dis% GST % Amount

1 EMBETA XR 50MG TAB 30`S INT 30049074 1 X10358 05/21 182.11 20.00 12.00 182.11

2 TELMA CT 80/12.5 TAB 15'S GLE 3004 1 FRT80602 05/20 297.00 20.00 12.00 297

Tax % SGST % SGST Amt. CGST % CGST Amt.

Notes:
12.00% 6.0 20.53 6.0 20.53

For Jadhav Chemist Total MRP Rs. 479.11

Name of the Discount@20.0 % Rs. 95.82

Pharmacist kaenat
Amount after Disc. Rs 383.29
PR Number G56797 Delivery Charges* 0

Cash Handling Charges* 20

Pharmacist Signature

Note: Total savings Rs. 95.82 Total Invoice Amount Rs. (Rounded Off) 403

Amount In Words : Four Hundred Three Rupees only.

*Charges inclusive of GST (HSN - 9997)
Customer Acknowledgement: I, Pritam Jana hereby recognise and accept the delivery of my order in full as prescribed by my doctor. I
acknowledge that the ordered medicines are for my own consumption and will not be used to sell to any third party until specified for.
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Whether reverse charge is applicable - No

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