TAX INVOICE Page 1 of 2

MEDLINE HEALTHCARE INDUSTRIES PRIVATE LIMITED Warehouse Address -

Off No. 4A, Visionnaire, SR. No. 232/1, 2 Plot No. 121, 122, MEDLINE HEALTHCARE INDUSTRIES PRIVATE LIMITED
Sakore Nagar, Pune 411014; Tel: 02067479000 Fax: 02067479001 Building No. B-2, Gala No. 1B, 1D & 2, City Link Warehousing Complex,
State Code : 27 Maharashtra Mumbai Nashik Highway, S.No. 120-121, Village-Vadape, Tal-Bhiwandi,
Website: in.medlineasia.com Email: CustomerService_MHI@medline.com Dist-Thane 421302, State Code - 27 Maharashtra
CIN : U51909PN2019FTC181932 Tel- +91 9156038005 Email- CustomerService_MHI@medline.com
GSTIN: 27AAMCM4219L1Z2 Drug License1- MH-TZ5-457416
PAN: AAMCM4219L MSME No. – UAM # MH26E0210211 Drug License2- MH-TZ5-457417
Bill To Ship To
C. NATVARLAL & CO. C. NATVARLAL & CO. Invoice No: 2022/MHI/000564
PRAVIN NIWAS,SHOP NO 2 AND 3,GR. FLR PRAVIN NIWAS,SHOP NO 2 AND 3,GR. FLR
Invoice Date: 4-Aug-2022
271/279,DR.CAWASJI HORMUSJI ST. 271/279,DR.CAWASJI HORMUSJI ST.
Customer PO No: by email
DHOBI TALAO, MUMBAI DHOBI TALAO, MUMBAI
MUMBAI, MH 400002 Place of Supply: 27 Maharashtra
MUMBAI, MH 400002
India India Payment Terms: Advance
GSTIN:27AACFC2010J1ZZ GSTIN:27AACFC2010J1ZZ Sales Order No: SOI1356
DL1:20B-143203 DL1:20B-143203 Contact No: 9820062869
DL2:21B-143204 DL2:21B-143204
PAN No.:AACFC2010J

Sr SKU Description HSN Case Qty UOM Rate CGST SGST Taxable Amt CGST Amt SGST Amt Amount
No Count % %

1 1690 INFANT NASAL CPAP CANNUL 90192010 10 5.00 CS 6500.00 6.0 6.0 32,500.00 1,950.00 1,950.00 36,400.00
A,SIZE 0

Exp Dt:. NA Lot: 74A2200512 Lot Qty: 5.00

2 1885 MICRO MIST NEBULIZER W/E LONG 90192010 50 20.00 CS 2500.00 6.0 6.0 50,000.00 3,000.00 3,000.00 56,000.00

Exp Dt:. NA Lot: 74J2000269 Lot Qty: 20.00

3 1886 MICRO MIST NEBULIZER W/E LONG 90192010 50 30.00 CS 2500.00 6.0 6.0 75,000.00 4,500.00 4,500.00 84,000.00

Exp Dt:. NA Lot: 74D2000404 Lot Qty: 30.00

4 1104 CANNULA,OVER-THE-EAR W/F 90192010 50 6.00 CS 1700.00 6.0 6.0 10,200.00 612.00 612.00 11,424.00
LARED NASAL PR

Exp Dt:. NA Lot: 74G2101238 Lot Qty: 1.00

Exp Dt:. NA Lot: 74G2102154 Lot Qty: 5.00
5 1041 MASK,MEDIUM CONC,ELONG,A 90192010 50 20.00 CS 2000.00 6.0 6.0 40,000.00 2,400.00 2,400.00 44,800.00
DULT

Exp Dt:. NA Lot: 74C2101450 Lot Qty: 9.00

Exp Dt:. NA Lot: 74F2102129 Lot Qty: 3.00
Exp Dt:. NA Lot: 74F2102389 Lot Qty: 8.00
 TAX INVOICE Page 2 of 2

MEDLINE HEALTHCARE INDUSTRIES PRIVATE LIMITED Warehouse Address -

Off No. 4A, Visionnaire, SR. No. 232/1, 2 Plot No. 121, 122, MEDLINE HEALTHCARE INDUSTRIES PRIVATE LIMITED
Sakore Nagar, Pune 411014; Tel: 02067479000 Fax: 02067479001 Building No. B-2, Gala No. 1B, 1D & 2, City Link Warehousing Complex,
State Code : 27 Maharashtra Mumbai Nashik Highway, S.No. 120-121, Village-Vadape, Tal-Bhiwandi,
Website: in.medlineasia.com Email: CustomerService_MHI@medline.com Dist-Thane 421302, State Code - 27 Maharashtra
CIN : U51909PN2019FTC181932 Tel- +91 9156038005 Email- CustomerService_MHI@medline.com
GSTIN: 27AAMCM4219L1Z2 Drug License1- MH-TZ5-457416
PAN: AAMCM4219L MSME No. – UAM # MH26E0210211 Drug License2- MH-TZ5-457417
Bill To Ship To
C. NATVARLAL & CO. C. NATVARLAL & CO. Invoice No: 2022/MHI/000564
PRAVIN NIWAS,SHOP NO 2 AND 3,GR. FLR PRAVIN NIWAS,SHOP NO 2 AND 3,GR. FLR
Invoice Date: 4-Aug-2022
271/279,DR.CAWASJI HORMUSJI ST. 271/279,DR.CAWASJI HORMUSJI ST.
Customer PO No: by email
DHOBI TALAO, MUMBAI DHOBI TALAO, MUMBAI
MUMBAI, MH 400002 Place of Supply: 27 Maharashtra
MUMBAI, MH 400002
India India Payment Terms: Advance
GSTIN:27AACFC2010J1ZZ GSTIN:27AACFC2010J1ZZ Sales Order No: SOI1356
DL1:20B-143203 DL1:20B-143203 Contact No: 9820062869
DL2:21B-143204 DL2:21B-143204
PAN No.:AACFC2010J

Sr SKU Description HSN Case Qty UOM Rate CGST SGST Taxable Amt CGST Amt SGST Amt Amount
No Count % %

6 1042 MASK,MEDIUM CONC,ELONG,P ED 90192010 50 6.00 CS 2500.00 6.0 6.0 15,000.00 900.00 900.00 16,800.00

Exp Dt:. 11/17/2026 Lot: 74L2101682 Lot Qty: 6.00

Total 222,700.00 13,362.00 13,362.00 249,424.00

Total Discount 0.00

Total Invoice Amount in words Freight
INR TWO LAC FORTY-NINE THOUSAND FOUR HUNDRED TWENTY-FOUR only
Grand Total 249,424.00

For MEDLINE HEALTHCARE INDUSTRIES PRIVATE LIMITED

Whether the Tax is payable on reverse charge basis - No
Interest @ 18% p.a. will be charged on delayed payments

(Authorized Signatory)