MEMO Original/Dupliacte/Triplicate

AYUSH DISTRIBUTORS
Memo No
CONSIGNEE AGENT FOR INTAS PHARMACEUTICALS LIMITED : 322CHL227102161
Memo Date : 07-Jan-2023
SHOP NO.94-95, GROUND,, 1ST,2ND & 3RD FLOOR,, RAIPUR - 492001. Phone:8827819400 Mobile :8827819400 , WARD NO 53 AUSHDHI VATIKA,,
DUMARTARAI, PAN:AYOPM4099B,FSSAI : 20521079001852 DrugLicNo.: 20B-41089, DrugLicNo:21B-41090 GSTNo.:22AYOPM4099B1ZD
State:CHATTISGARH
Details of Receiver(Billed to) DL NO : 20B/27079 Details of Consignee(Shipped to)
Name : VIJAY PHARMA [ 9002134 ] DL NO : 21B/27080 Name : VIJAY PHARMA [ 9002134 ]
Address : SHOP NO.1 NEW BLOCK FARISHTA Place of supply & State : CHATTISGARH , RAIPUR (C.G.)
Addres : SHOP NO.1 NEW BLOCK FARISHTA PAN NO. : AIXPM7698H 20521079001864
COMPLEX Place of Delivery : CHATTISGARH , RAIPUR (C.G.)
COMPLEX State : CHATTISGARH
N/A
N/A GSTIN/Unique ID : 22AIXPM7698H1ZD RAIPUR (C.G.) - 492001Mo. 9329750748 , 0
RAIPUR (C.G.) - 492001
Mo. 9329750748 , 0 HO Order No : 322ROR227101673 State : CHATTISGARH
GSTIN/Unique ID : 22AIXPM7698H1ZD

Sr.# Material HSN NO. Batch ExpDt. Qty UOM MRP Rate Taxable Amt. Tax% SGST CGST IGST TotalAmt

INNOVA
AAGYA BIOTECH PRIVATE LIMITED,Uttrakhand
1 CEPOCEF-200 10 TAB 30042019 BT-221016 9-24 50 NOS. 346.00 56.00 2,800.00 12.00 168.00 168.00 0.00 3,136.00

Remarks : Total: 2,800.00

Tax Amount 336.00

Expected TDS Amount 2.80

Invoice Total 3,133.20

Rounding off(+/-) -0.20

Net Amount 3,133.00

Invoice Total (In Words) :
RUPEES THREE THOUSAND ONE HUNDRED
THIRTY-THREE ONLY

Printed Date : 07-Jan-2023 Page 1 of 1