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Description of
items
Qty
(kg)
Rate
(USD)
Amount
(USD)
Total
(USD)
1.
2 kg
108.00
216.00
359.00
1 kg
143.00
143.00
USD 359
Certified that the items on this sheet have been For Adjustment payment
1. Consumable
procured by me in good conditions
Balance now payable nil
On A/C ofAlready paid 359 USD
(Amount In words)
( Three hundred fifty nine USD only)
Sign. of Buyers
Name (s): Dr. J. Bijwe
E. Code (s): 15699
Sign of Store keeper
Sign PI
E Code:15699
HOD/ Nominee to sign after ensuring that S.NO. As put at the top of the previous page is in the order.
Sign. Of HOD
Or Nominee
22.4.2016
Particulars of Items
Quantity
Balance
Recd.
Issued
2 kg
2 kg
1 kg
1 kg
Nil
Issued to sign
& E. Code