Tax Invoice Invoice Number: C049-19-00697613

Original for Recipient

Keep the original invoice and barcode on medicines intact for returns

Sold By Bill To / Ship To (Patient)

M/S Laxmi Chemist Order Id: 17188897
Ravinarayan Prasty
670 Uttar Panchanna Gram, Paschmi Chowbhaga, Order Date: 2020-03-19 Plot no107, Krishna Garden Annex,
First Floor, VIP Nagar, Tiljala, Kolkata
Jagamara, Bhubaneswar, ,
Invoice Date: 2020-03-19 Bhubaneshwar, Orissa, 751030
DL Number WB/KOL/NBO/R/277130(2024-10-24),
Doctor Name Dr. Prachi Gupta
WB/KOL/BIO/R/277130(2024-10-24),

GSTIN 19AAHFL1873B1ZE POS : 97-Orissa

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

1 RENOALFA TABLET 10'S ALN 30041010 T-1907152 12/20 200.00 40.00 160.00 5.00 6 1,200

ESOGRESS 40MG STRIP

2 LA 30049039 T0291912 10/21 82.00 16.40 65.60 12.00 3 246
OF 10 TABLETS

3 LANUM 667MG TAB LA 3004 T0421929 07/22 42.00 8.40 33.60 12.00 6 252

SOBISIS 500MG STRIP OF

4 LA 30041010 T0831967 07/22 35.00 7.00 28.00 12.00 6 210
10 TABLETS

Taxable Value IGST % IGST Amt.

Notes:
505.71 12.0 60.69
0.0 18.0 0
914.29 5.0 45.71
Total 1420.0 0.0 106.4

MRP Total 1,908

For M/S Laxmi Chemist PharmEasy Savings @ 20.0% -381.6
Name of the Subtotal 1526.4
Pharmacist Debabrata
Rounding Off -0.4
PR Number A-15126

Pharmacist Signature

(Rounded Off)
Note: Total savings Rs. 382.00 Total Invoice Amount Rs. 1,526

Amount In Words : One thousand Five Hundred Twenty Six Rupees only.
*Charges inclusive of GST (HSN - 9997)
Customer Acknowledgement: I,Ravinarayan Prasty 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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