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WAY BILL
[See sub-rule (3) of rule 79]
1. Dealer of Odisha
(To whom waybill is issued
Name: INDUSTRIAL CHAIN AND MILLS STORE
21W-17062613942
TIN: 21131101071
2. Consignor of goods
Name: MA - KALI ENTERPRISE
Delivery to the After purchase Branch Consignment Execution of Transfer of Any Other
buyer by self/by agent transfer sale works contract right to use reason,(plea
se specify)
Yes
Sl.N Commodity & Code Invoice / Challan (in case of Quantity Value (in Rs)
o sale / Purchase) / Other
document (other than sale /
purchase)
Sl. Number Date
1 Hardware goods-7290 16/16-17 3/3/2017 4.0000 24,990.00
Bags
10. Vehicle / Carrier Detail - Vehicle Regd. Driver's Name Lorry / Transport / Railway
21W-17062613942
No. NA Receipt No.
NA NA
11. Way bill issuing/approving Office 12. Way bill issuing/approving authority (Name &
Desgination)
Bhubaneswar I Circle
WAY BILL No:
electronic Waybill.