Retail Invoice / Bill

Toll Free No.: 72007-12345 / Email: cs@netmeds.com

HEALTHSCAPE TECHNOLOGY LLP Original for Recipient

D.NO B-9/4 GROUND FLOOR IDA UPPAL, Duplicate for Transporter
Triplicate for Supplier
RAMANTHAPUR KHALSA(V), UPPAL(M),
GSTIN : 36AALFH7207B1ZM
MEDCHAL - MALKAJGIRI(DIST.), Drug Licence No : Form 20 - TS/MDL/2019-43933
HYDERABAD - 500039 Form 21 - TS/MDL/2019-43933
Form 20B - TS/MDL/2019-43933
Dated:29.1.2019

Invoice No : CS621-20-427252 Order No : 16075077099007341ASO1

Invoice Date : 28-12-2020 Delivery Man : Delhivery (Prepaid)

Patient Name : Mr/Mrs DEEPAK AGRAWAL

Doctor Name : Dr DR PANKAJ ISHWAR PATEL
Customer GST No : -

Billing Address : KHUSHBOO AGRAWAL Shipping Address : NITIN AGRAWAL

H/O K K SINHA, NEAR JAIN MANDIR, NORTH CONGRESS MAIDAN, H/O K K SINHA, NEAR JAIN MANDIR, NORTH CONGRESS MAIDAN,
KADAM KUAN ,NEAR JAIN MANDIR KADAM KUAN,
Patna, Bihar - 800003, India. Mobile: 9308171977 Patna, Bihar - 800003, India. Mobile: 9308171977
Place of supply (State Name) : Bihar Landmark : NEAR JAIN MANDIR
Whether tax is payable on reverse charge basis : N

IGST
Disc Taxable Total Amt
S.No. Mfr Description Of Goods HSN MRP Batch No Expiry Qty Rate Total Rate Amt
Amt Amt (incl. tax)

1 Torrent Azulix MF 2mg Tablet 3004 190.102KW5G005 04/22 80 169.73 13578.4 0.00 1 3 5 7 8 . 4 12 1629.4 15207

0% 5% 12% 18% 28% Total

IGST - - - - - 1629.4

Total Item : 1 Total Qty : 40 Sub Total : 15207

Wallet Amt :- Discount Amount : (-)0.00

PREPAID Grand Total : 15207.00

Declaration :
We Declare that this Invoice shows the actual price of the Goods described and that all particulars are true and correct.