Tax Invoice Number: C041-19-00070096

Original for Receipt

Keep the original invoice and barcode on medicines intact for returns

Sold By Bill To / Ship To (Patient)

Axelia Pharma (A unit of Axelia Order Id: 12263343
Anjana
Shop no 1188, No 61, Ground floor, Ashok Nagar, 2019-09-28
10th cross, 2nd main, BSK 1st stage, 2nd block,
Order Date: No 127 5th main 5th cross kashi nagar,
Bangalore - 560050 Yelchanaahalli, , Bengaluru,
Invoice Date: 2019-09-29 Karnataka, 560078
DL Number KA-B21-181350(2024-07-03), KA-B21-181351(2024-07-03), KA-
Doctor Dr. KURAPATI
B21-181352(2024-07-03), KA-B21-181353(2024-07-03),
AISHWARYA
GSTIN 29AARCA8488J1ZM POS : 29-Karnataka

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

1 TEGRITAL CR 400MG TAB NOV 30049099 18 198009MB 07/22 33.42 20.00 12.00 601.56

Tax % SGST % SGST Amt. CGST % CGST Amt.

Notes:
12.0% 6.0 25.92 6.0 25.92
18.0% 9.0 0 9.0 0

For Axelia Pharma (A unit of Axelia Total MRP Rs. 601.56

Name of the Solutions Pvt. Ltd.) Total Item Discount Rs. 120.24
Pharmacist Syed Zakir Hussain
Order Discount Rs. 0
PR Number 48836 Amount after Disc. Rs 481.32

Pharmacist Signature

(Rounded Off)
Note: Total savings Rs. 120.24 Total Invoice Amount 481

Amount In Words : Four Hundred Eighty One Rupees only.

*Charges inclusive of GST (HSN - 9997)
Customer Acknowledgement: I,Anjana 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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