Debit Note

Madan & Brothers - (from 1-Apr-23) Debit Note No. Dated

25/221, B- Sarsauli, Ordali Bazar 3 17-Jul-23
Varanasi Original Invoice No. & Date. Other References
GSTIN/UIN: 09BCIPS0958Q1ZM
State Name : Uttar Pradesh, Code : 09

Buyer (Bill to)

ABBOTT HEALTHCARE PVT.LTD.

GSTIN/UIN : 09AAACK3935D1ZQ
State Name : Uttar Pradesh, Code : 09

Sl Description of Goods HSN/SAC GST Quantity Rate per Amount

No. Rate Shipped Billed

1 SIMILAC PLUS 3 19011090 18 % 16.00 PCS 16.00 PCS 544.88 PCS 8,718.08
400GM TIN 760/-
2 ENSURE DIABTIC 21069091 12 % 1.00 PCS 1.00 PCS 547.63 PCS 547.63
VANILA 400GM BIJ
725/-
3 ENSURE DIABETIC 21069091 12 % 1.00 PCS 1.00 PCS 1,125.48 PCS 1,125.48
VANILLA 1KG BIB
1490/-
4 ENSURE PLUS HMB 21069099 18 % 1.00 PCS 1.00 PCS 537.71 PCS 537.71
VANILA 400GM BIJ
750/-
5 PEDIASURE 19011090 18 % 1.00 PCS 1.00 PCS 442.20 PCS 442.20
CHOCOLATE 400GM
BIJ 610/-
6 PEDIASURE VANILA 19011090 18 % 3.00 PCS 3.00 PCS 239.22 PCS 717.66
200GM BIJ 330/-

continued ...

This is a Computer Generated Document

 Debit Note(Page 2)

Madan & Brothers - (from 1-Apr-23) Debit Note No. Dated

25/221, B- Sarsauli, Ordali Bazar 3 17-Jul-23
Varanasi Original Invoice No. & Date. Other References
GSTIN/UIN: 09BCIPS0958Q1ZM
State Name : Uttar Pradesh, Code : 09

Buyer (Bill to)

ABBOTT HEALTHCARE PVT.LTD.

GSTIN/UIN : 09AAACK3935D1ZQ
State Name : Uttar Pradesh, Code : 09

Sl Description of Goods HSN/SAC GST Quantity Rate per Amount

No. Rate Shipped Billed

7 PEDIASURE VANILA 19011090 18 % 1.00 PCS 1.00 PCS 442.20 PCS 442.20
400GM BIJ 610/-
8 PEDIASURE VANILA 19011090 18 % 1.00 PCS 1.00 PCS 935.14 PCS 935.14
1KG BIB 1290/-
9 ENSURE 19019090 18 % 2.00 PCS 2.00 PCS 444.51 PCS 889.02
CHOCOLATE 400GM
BIB 620/-
10 PEDIASURE 19011090 18 % 1.00 PCS 1.00 PCS 420.45 PCS 420.45
CHOCOLATE 400GM
BIJ 580/-
11 SIMILAC MT-2 19011090 18 % 4.00 PCS 4.00 PCS 269.41 PCS 1,077.64
400GM BIB 380/-
12 SIMILAC MT -3 19011090 18 % 1.00 PCS 1.00 PCS 255.23 PCS 255.23
400GM BIB-J 360/-
13 SIMILAC MT-1 19011090 18 % 2.00 PCS 2.00 PCS 269.41 PCS 538.82
400GM BIJ-J 380/-

continued ...

This is a Computer Generated Document

 Debit Note(Page 3)

Madan & Brothers - (from 1-Apr-23) Debit Note No. Dated

25/221, B- Sarsauli, Ordali Bazar 3 17-Jul-23
Varanasi Original Invoice No. & Date. Other References
GSTIN/UIN: 09BCIPS0958Q1ZM
State Name : Uttar Pradesh, Code : 09

Buyer (Bill to)

ABBOTT HEALTHCARE PVT.LTD.

GSTIN/UIN : 09AAACK3935D1ZQ
State Name : Uttar Pradesh, Code : 09

Sl Description of Goods HSN/SAC GST Quantity Rate per Amount

No. Rate Shipped Billed

14 SIMILAC MT-2NO 19011090 18 % 2.00 PCS 2.00 PCS 397.91 PCS 795.82
400GM BIB 555/-
15 SIMILAC MT 1NO 19011090 18 % 2.00 PCS 2.00 PCS 397.91 PCS 795.82
400GM BIB 555/-
16 SIMILAC 3NO. 19011090 18 % 3.00 PCS 3.00 PCS 269.41 PCS 808.23
400GM BIB-J 380/-

19,047.13
CGST@ 9% 9 % 1,563.65
SGST@ 9% 9 % 1,563.65
CGST@ 6% 6 % 100.39
SGST @ 6% 6 % 100.39

continued ...

This is a Computer Generated Document

 Debit Note(Page 4)

Madan & Brothers - (from 1-Apr-23) Debit Note No. Dated

25/221, B- Sarsauli, Ordali Bazar 3 17-Jul-23
Varanasi Original Invoice No. & Date. Other References
GSTIN/UIN: 09BCIPS0958Q1ZM
State Name : Uttar Pradesh, Code : 09

Buyer (Bill to)

ABBOTT HEALTHCARE PVT.LTD.

GSTIN/UIN : 09AAACK3935D1ZQ
State Name : Uttar Pradesh, Code : 09

Sl Description of Goods HSN/SAC GST Quantity Rate per Amount

No. Rate Shipped Billed

Less : R/off (-)0.21

Total 42.00 PCS 42.00 PCS 22,375.00

Amount Chargeable (in words) E. & O.E
Indian Rupees Twenty Two Thousand Three Hundred Seventy Five Only
HSN/SAC Taxable CGST SGST/UTGST Total
Value Rate Amount Rate Amount Tax Amount
19011090 15,947.29 9% 1,435.25 9% 1,435.25 2,870.50
21069091 1,673.11 6% 100.39 6% 100.39 200.78
21069099 537.71 9% 48.39 9% 48.39 96.78
19019090 889.02 9% 80.01 9% 80.01 160.02
Total 19,047.13 1,664.04 1,664.04 3,328.08

Tax Amount (in words) : Indian Rupees Three Thousand Three Hundred Twenty Eight and Eight paise
Only

Company’s Bank Details

Bank Name : UNION BANK OF INDIA
A/c No. : 596505040000101
Branch & IFS Code : BHOJUBEER & UBIN0559652
for Madan & Brothers - (from 1-Apr-23)

Authorised Signatory

This is a Computer Generated Document