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