Tax Invoice Number: C029-19-00117005

Original for Receipt

Keep the original invoice and barcode on medicines intact for returns

Sold By Bill To / Ship To (Patient)

BE WELL PHARMACY Order Id: 12397581
M Pavan Kumar
8-1-523/228, Brindavan Colony, Behind Galaxy 2019-10-02
Theater, Tolichowki, Hyderabad - 500008
Order Date: VENKATADRI APPARTMENT, GF1,
D.NO: 5-51-33, 5/18BRODIPET,
Invoice Date: 2019-10-03 PH.NO: 9391912182, , Guntur,
DL Number TS/HYD/2018-39769(2023-09-11),
Doctor Not Applicable

GSTIN 36AATFB6503G1ZD POS : 37-Andhra Pradesh

S Description of Goods MFR/MKT HSN Code Qty Batch No Exp MRP Dis% GST % Amount

1 NEUROGARD TAB VAN 2106 10 FVNZ401 10/20 113.99 30.00 18.00 1,139.9

2 GEMITROL KIT TOR 30045020 12 ST73F003 12/20 164.15 30.00 12.00 1,969.8

Tax % IGST % IGST Amt.

Notes:
12.0% 12.0 147.72
18.0% 18.0 121.7

For BE WELL PHARMACY Total MRP Rs. 3,109.7

Name of the Total Item Discount Rs. 621.96

Pharmacist Shaik Ayesha
Order Discount Rs. 310.97
PR Number 129383/A1 Amount after Disc. Rs 2,176.77

Pharmacist Signature

(Rounded Off)
Note: Total savings Rs. 932.93 Total Invoice Amount Rs. 2,177

Amount In Words : Two Thousand One Hundred Seventy Seven Rupees only.
*Charges inclusive of GST (HSN - 9997)
Customer Acknowledgement: I,M Pavan Kumar 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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