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State Code : State Code :
GSTIN. : GSTIN. :
Sr. Description of Goods HSNCODE M.R.P Qty in Qty in Rate Discount Taxable CGST/IGST SGST/UTGST Amount
No. Box Ltr Value
Total
Stock Received by :
Certified that the particular given above are true and correct
Authorised Signatory
Warrenty :- We here by certify that goods mentioned in this invoice is/are warranted to
be of the nature and Quality which purpose to be FSSAI LIC No. Name : Round Off :
Outstanding Amount : as on 25-Mar-2019 Designation : Net Payable Amount :
Scheme Applicable Amount :
Note: * Material not in scheme ; # Scheme Material
SUBJECT TO JURISDICTION ONLY