| |
|
|
CHEMIND,
TC-35-4984, Chemind House,
Machingal Lane, M.G.Road, Thrissur-1, Kerala, India. |
|
Ph; (0091)-487-2335173,
Mob: 9846033157,
Fax: 91-0487-2336641
Email :
mail@chemindonline.com,
Website :
www.chemindonline.com |
|
|
|
| |
COMPANY NAME : |
|
|
|
| |
ADDRESS
: |
|
|
|
| |
PHONE : |
EMAIL : |
|
FAX : |
|
| |
DATE OF ORDER
: |
|
|
|
| |
KGST : |
CST : |
|
|
| |
PURCHASE ORDER NO.
: |
DRUG LICENCE NO.
: |
|
|
|
| |
POISON LICENCE NO.
: |
|
|
|
|
|
| |
| S.No. |
ITEM CODE |
UNIT |
DESCRIPTION |
QTY |
RATE |
TOTAL |
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
GRAND TOTAL : |
|
|
| |
| |
YOUR MESSAGE : |
|
| |
|
|
| |
AUTHORIZED SIGNATORY
|
|
|
| |
|