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Retail Invoice / Bill

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

HEALTHSCAPE TECHNOLOGY LLP Original for Recipient


H/NO-117/4/1, Duplicate for Transporter
Triplicate for Supplier
BADU 1ST MAIN ROAD,
GSTIN : 19AALFH7207B1ZI
WARD NO:21, GROUND FLOOR Drug Licence No : Form 21B : (WB/PGN/BIO/W/199246)
BARASAT MUNICIPALITY - 700128 Form 20B : (WB/PGN/NBO/W/199246)

Invoice No : CS621-19-111917 Order No : 1563760516001076WSO1


Invoice Date : 24-07-2019 Delivery Man : XpressBees (Prepaid)

Patient Name : Mr/Mrs PRABHA VERMA


Doctor Name : Dr AK VERMA
Customer GST No : -

Billing Address : Dr. A.K Verma Shipping Address : Dr. A.K Verma
TOWER - 7/ FLAT NO. 903 (T-7/903), Alaknanda Enclave, Uttar Pradesh TOWER - 7/ FLAT NO. 903 (T-7/903), Alaknanda Enclave, Uttar Pradesh
Awadh Vihar Yojana, Amar Shaheed Path, Lucknow Near G.D Goenka Awadh Vihar Yojana, Amar Shaheed Path, Lucknow Near G.D Goenka
Public School Public School,
Lucknow, UTTAR PRADESH - 226001, India. Mobile: 9839876396 Lucknow, UTTAR PRADESH - 226001, India. Mobile: 9839876396
Place of supply (State Name) : UTTAR PRADESH Whether tax is payable on reverse charge basis : N

Disc Taxable IGST Total Amt


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

1 MEDLEY Vogli M 0.2mg Tablet 10'S 3004 96.50 E81402 09/20 12 86.16 1033.92 0.00 1033.92 12 124.07 1157.99

0% 5% 12% 18% 28% Total


IGST - - 124.07 - - 124.07

Total Item : 1 Total Qty : 12 Sub Total : 1033.92


Discount Amount : (-)0.00
Rs. In Words: One Thousand One Hundred Fifty Eight Rupees only Total Tax Amount : 124.07

PREPAID Grand Total : 1158.00

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

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