Tax Invoice: Gstin PAN Drug Licence No

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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: CSHX03230037536 Order No : 16848531099027529ASO1


Invoice Date : 24-05-2023 Delivery Man : Bdart (Prepaid)

Doctor Name : Dr SOUNDARYA BONI Patient Name : Mr/Mrs MRSSIVA 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)

1 Sun Pha Moisturex Cream 100gm 30049099 275.00 SXE0262A 01/25 1 245.54 245.54 0.00 245.54 6 14.73 6 14.73 275.00
Revlamer 800mg Tablet
2 Sun Pha 30049099 185.00 GKD1885A 10/24 2 165.18 330.36 0.00 330.36 6 19.82 6 19.82 370.00
10'S
3 Glenmar Tacroz Forte Lotion 20ml 30049099 750.00 G22099 03/24 1 669.64 669.64 0.00 669.64 6 40.18 6 40.18 750.00

0% 2.5% 6% 9% 14% Total


CGST - - 74.73 - - 74.73
SGST - - 74.73 - - 74.73

Total Item : 3 Total Qty : 4 Sub Total : 1245.54


Discount Amount : -0.00
Total Taxable Amount : 1245.54
Rs. In Words: One Thousand Three Hundred Ninety Five Rupees only Total Tax Amount : 149.46
Round Off : 0.00

Paid by : juspay / simpl / e-Wallets-2023-05-23 20:15:12.000 Grand Total : 1395.00

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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