Tax Invoice

Netmeds CS Number: 72007-12345 / Email: cs@netmeds.com

RELIANCE RETAIL LIMITED Original for Recipient

PLOT NO B1, NORTH FACING, Duplicate for Transporter

Triplicate for Supplier
GROUND AND MEZZANINE FLOOR, NORTH WEST GSTIN : 33AABCR1718E1ZW
ENTERANCE PAN : AABCR1718E
CMBTT TRUCK TERMINAL MADHAVARAM, MADHAVARAM
Drug Licence No : TN-05-20B-00084 & TN-05-21B-00084
TN-05-20-00025 & TN-05-21-00025
TALUK
FSSAI : 12420023002117
CHENNAI - 600060

STATE CODE: 33, TN

Invoice No: CSHX03230057806 Order No : 16865697809019958ASO4

Invoice Date : 15-06-2023 Delivery Man : Bdart (Prepaid)

Doctor Name : Dr PARAKRAM SINGH SHAKTAWAT Patient Name : Mr/Mrs SIVA PRIYA

Billing Address : siva priya Shipping Address : siva priya

Flat F1 Vigneswara Dhanalxmi Apt. Bharati Nagar Main Road ,Zamin Flat F1 Vigneswara Dhanalxmi Apt. Bharati Nagar Main Road ,
Pallavaram Pallavaram Kanchipuram, Tamil Nadu , tamil nadu - 600043, India. Mobile:
Kanchipuram, Tamil Nadu , tamil nadu - 600043, India. Mobile: 8939825856 8939825856
Place of supply (State Name) : tamil nadu - 33 Landmark : Zamin Pallavaram Pallavaram

State Code: 33, TN Whether tax is payable on reverse charge basis : N

Disc Taxable CGST SGST/UGST Total Amt

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

Revlamer 800mg Tablet

1 Sun Pha 30049099 185.00 GKE0141A 12/24 2 165.18 330.36 59.46 270.90 6 16.25 6 16.25 303.40
10'S
2 Ipca La Lacsoft Lotion 50ml 30049099 205.00 IF11 06/24 3 183.04 549.12 98.84 450.28 6 27.02 6 27.02 504.32

3 Lupin L T Vobit 2mg Tablet 15'S 30049099 371.00 U202157 09/24 8 331.25 2650.00 477.00 2173.00 6 130.38 6 130.38 2433.76

0% 2.5% 6% 9% 14% Total

CGST - - 173.65 - - 173.65
SGST - - 173.65 - - 173.65

Total Item : 3 Total Qty : 13 Sub Total : 3529.48

Discount Amount : -635.30
Total Taxable Amount : 2894.18
Rs. In Words: Three Thousand Two Hundred Forty One Rupees only Total Tax Amount : 347.30
Round Off : -0.48

Paid by : juspay / simpl-2023-06-12 17:06:23.000 Grand Total : 3241.00

*** Your Total Savings: Rs.635.30 ***

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

Registered Office- 3rd Floor, Court House, Lokmanya Tilak Marg, Dhobi Tala, Mumbai-400002 Phone-+91-22 67673800
CIN -U01100MH1999PLC120563 PAN- AABCR1718E Website- www.relianceretail.com Toll-18001027382 email-customerservice@ril.com
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