Tax Invoice Number: C052-19-00007591

Original for Receipt

Keep the original invoice and barcode on medicines intact for returns

Sold By Bill To / Ship To (Patient)

Axelia Pharmacy Order Id: 13871796
Kasturi Devi
Shop No-46 Ground Floor Sindhi Colony Banipark Order Date: 2019-11-26 14, Jagan Vihar, Thekra Road,
Jaipur
Borkhera, , Kota, Rajasthan, 324001
Invoice Date: 2019-11-27

DL Number DRUG/2019-20/25971(2023-07-19), DRUG/2019-20/25973(2023-

Doctor Dr. B.M. VARMA
07-19), DRUG/2019-20/25972(2023-07-19), DRUG/2019-
20/25974(2023-07-19),
GSTIN 08AARCA8488J1ZQ POS : 08-Rajasthan

S Description of Goods MFR/MK HSN Batch No Exp MRP Discount Unit Price GST Qty Amount

GEMER FORTE 2MG TAB

1 SUN 30049099 ESU1256 07/21 105.00 21.00 84.00 12.00 1 105
10'S
GEMER FORTE 2MG TAB
2 SUN 30049099 ESU0946 05/21 96.00 19.20 76.80 12.00 5 480
10'S

Taxable Value SGST % SGST Amt. CGST % CGST Amt.

Notes:
417.86 6.0 25.07 6.0 25.07
0.0 9.0 0 9.0 0
Total 417.86 0.0 25.07 0.0 25.07

For Axelia Pharmacy MRP Total 585

Name of the PharmEasy Savings @ 20.0% -117.0

Pharmacist Ajeet Choudhary
Subtotal 468.0

PR Number 49634

Pharmacist Signature

(Rounded Off)
Note: Total savings Rs. 117.00 Total Invoice Amount 468

Amount In Words : Four Hundred Sixty Eight Rupees only.

*Charges inclusive of GST (HSN - 9997)
Customer Acknowledgement: I,Kasturi Devi hereby recognise and accept the delivery of my order in full as prescribed by my doctor. I
acknowledge that the ordered medicines are for my own consumption and will not be used to sell to any third party until specified for.
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Whether reverse charge is applicable - No

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