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LAKSHMI MEDICAL & GENERAL STORES

(WHOLESALE & RETAIL) a QUALIFIED DISPENSING CHEMISTS & DRUGGISTS a


D.No.: 7-12-99/3, Uppudi Road, REPALLE - 522 265, Guntur Dt., 08648 - 222951, 222952 (R), Mobile : 98 48 56 15 83, 89 85 43 29 51

D.L..No.: Form 20 : 18/AP/GN(T)2009/R/G Form 21 : 18/AP/GN(T)2009/R/G Pt. Name :


QTY.

WISH YOU SPEEDY RECOVERY


Dr. Name :

Form 20B : 03/AP/GN(T)/2012/W/G Form 21B : 03/AP/GN(T)/2012/W/G Bill No.:


EXP. AMOUNT

Date :
MFG. NAME BATCH NO. SCH

NAME OF THE DRUG

TOTAL :
GENERAL WARRANTY : On the basis of the warranty given to us by the Suppliers, we do hereby give the warranty that the goods supplied herein do not contravene in any way the provisions of Sec. 19 of Drugs Act, 1940.

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We serve almighty through quality. Pioneers in Drug Dispensing, Surgical Items & Life saving drugs. Visit us for Disease Free Today & Healthful Tomorrow. We add Good Health to Life. Once goods sold cannot be taken back or exchanged. E. & O.E.,

Signature

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