Original copy for recipient

DELIVERY CHALLAN - RTV Duplicate for consignee

Triplicate for consignor

Consignor: THE MEDICAL STORES

8,G T ROAD (SOUTH ),HOWRAH-711101
Contact Person : SUMITKUMAR
Contact No : 9051752734, 9051752734 Document No : ROSF11220004452
GSTIN : UNREGISTERED Date : 2022-06-06 17:47:20
DL.No : WB/HWH/BIO/R/199558-21, WB/HWH/NBO/R/199558-20
Page No : Page 1 of 1
State : WEST BENGAL, 19

Consignee: RELIANCE RETAIL LIMITED

PPD-2,MOUZA-SANDHIPUR,J.L NO.04,R.S.DAG NO.801,802,806,807,808,809,817&819(ALL PART),POLICE
STATION-SANKRAIL,RRL HWRH-711302
GSTIN : 19AABCR1718E1ZM
DL.No : WB/HWH/NBO/R/592659-20-20, WB/HWH/NBO/W/592658-20B-20B,
WB/HWH/BIO/R/592659-21-21, WB/HWH/BIO/W/592658-21B-21B
FSSAI : 12821008000290
State : WEST BENGAL, 19

Place of Supply : WEST BENGAL- 19

Mfr. HSN Description of Goods CGST SGST

Amount
S.No Free
Batch Exp. Date MRP PTR Rate Qty Amount Disc% Disc. Amt Taxable Amt Rate Amt. Rate Amt. Incl.Tax
Qty

Micro Labs 30049061 Dolo 650mg Tablet 15'S

1
DOBS2723 11-25 30.91 22.08 17.52 3 0 52.56 0.00 0.00 52.56 6.0 3.15 6.0 3.15 58.87
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Cipla Ltd 30049099 Norflox TZ RF Tablet 10'S
2
RC1196 11-24 97.71 69.79 54.67 3 0 164.01 0.00 0.00 164.01 6.0 9.84 6.0 9.84 183.69
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Franco Ind 30049099 Sorbiline Syrup 200ml
3
S22015 01-25 153.50 109.64 93.19 3 0 279.57 0.00 0.00 279.57 6.0 16.77 6.0 16.77 313.12
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Lupin Ltd 30049099 Rablet D Capsule 10'S
4
RD220205 07-23 183.00 130.71 112.30 2 0 224.60 0.00 0.00 224.60 6.0 13.48 6.0 13.48 251.55
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Pfizer Lim 30049032 GELUSIL MPS ORIGINAL MINT FLAVOUR SUGAR FREE Liquid 200ml
5
2119450E 11-23 126.49 90.35 74.54 2 0 149.08 0.00 0.00 149.08 6.0 8.94 6.0 8.94 166.97
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Zuventus H 30045020 Bevon Suspension 200ml
6
Z06AH22011 06-23 158.85 113.46 96.44 2 0 192.88 0.00 0.00 192.88 6.0 11.57 6.0 11.57 216.03
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
Medley Pha 30045090 R B Tone Syrup 200ml
7
E20262 01-24 184.50 131.78 112.01 1 0 112.01 0.00 0.00 112.01 6.0 6.72 6.0 6.72 125.45
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return
PROCTER & 30045090 Neurobion Forte Tablet 30'S
8
2042C84301 07-23 34.70 23.94 21.79 10 0 217.90 0.00 0.00 217.90 6.0 13.07 6.0 13.07 244.05
Sale Inv: CSSF11220054670 Dt.: 2022-05-29 10:58:00, Reason: Damaged Stock Return

Tax % CGST SGST IGST Total

Sub Total : 1,392.61
0% - - - -
Discount Amount : 0.00
5% - - - -
Tax Amount : 167.08
12% 83.54 83.54 - 167.08
Round Off : 0.31
18% - - - -
Net Amount : 1,560.00
28% - - - -

Total Items :8 Total Qty : 26

for THE MEDICAL STORES
Total Invoice Value Rs (in words): One Thousand Five Hundred and Sixty Rupees
Only

Total Amount Payable Rs (in words): One Thousand Five Hundred and Sixty Authorized signatory
Rupees Only