Iconkrishi Institute ofMedical Sciences Pvt.

Ltd
MULTI SUPERSPECIALITY HOSPITAL
#32-11-02,Sheela Nagar,VISAKHAPATNAM-500034
Tel No : 040 23547532 Fax : 040 23548243
GST No : 37AAECI8355H1Z9
D/L No : AP/03/02/2018-146683
Domestic Purchase Order
GS01 : GENST-B2-GR-01

To PO No : 1310031167 Format No : KIMS/PUR/F/03

Indent Nos : 1100054910
SRI SAI PRINTERS PO Date : 26-Apr-25

PO Status : Hold
Quote :
D.NO.39-20-1/3, NEAR RAMALAYAM, MADHAVADHARA,
Credit Period / : 15 days from the date of No
VISAKHAPATNAM.
Payment Terms supply
Quote Date :
ANDHRA PRADESH-530007 Currency : INR
Created By : K Rajani
Contact Person Name :
Approved By :
Email id : saijee08@gmail.com Vendor D/L No :
Phone No : 8500937900 Vendor GSTIN No : 37BEHPB5971H1ZD

Dear Sir/ Madam,

Sub: Supply of Items for our Hospital
We are pleasure to place purchase orders for supply of the following items.

CGST CGST SGST SGST

S.No Material Description HSN Code Qty Bonus UOM Unit Rate Disc% Taxable Value
% Amount % Amount

1 ANTIMICROBIAL STEWARDSHIP PROGRAM (A4 BOTH SIDE) 10010003 30 0.00 NO 88.00 0.00 2640.00 9.00 237.60 9.00 237.60

2 MULTIDISCIPLINARY INTENSIVE CARE UNIT 10010003 3,000 0.00 PAD 11.50 0.00 34500.00 9.00 3105.00 9.00 3105.00

3 DIET ORDER CHART 10010000 30 0.00 PAD 78.00 0.00 2340.00 9.00 210.60 9.00 210.60

FORM OF APPLICATION FOR CLAIMING REFUND OF MEDICAL

4 10010000 30 0.00 PAD 78.00 0.00 2340.00 9.00 210.60 9.00 210.60
EXPENSES

5 MEDICAL CASE SHEET 10060000 30 0.00 PAD 88.00 0.00 2640.00 9.00 237.60 9.00 237.60

6 2D ECHO CARDIOGRAPHIC REPORT 10010003 30 0.00 NO 88.00 0.00 2640.00 9.00 237.60 9.00 237.60

CONSENT FORM FOR PROCEDURE/SURGERY TREATMENT A4

7 SIZE 70GSM BOTH SIDE 99714500 30 0.00 NO 88.00 0.00 2640.00 9.00 237.60 9.00 237.60
PRINTING(TELUGU/ENGLISH)

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8 EMERGENCY DEPARTMENT REQUEST FOR ADMISSION 63079018 30 0.00 PAD 88.00 0.00 2640.00 9.00 237.60 9.00 237.60

9 PMR SHEET 10010003 30 0.00 PAD 88.00 0.00 2640.00 9.00 237.60 9.00 237.60

Total Value 55020.00 4951.80 4951.80

PO Value in words: Sixty Four Thousand Nine Hundred Twenty Three Rupees Sixty Paise

Terms & Conditions : Sub Total : 55020.00

1)Expiry Date of the Material supplied should not be less than 1 year from the date of approved purchase order. Discount value : 0.00
2) Cold Storage Material should be maintained as per the recommended temperature given by the manufacturer.
3) The Batch number, Expiry date and MRP of the material brought must be accurately mentioned in the Sub Total (After discount) : 55020.00
invoice copy.
4)Delivery at our hospital stores after entry at main gate between 9 AM and 4 PM. GST Amount : 9903.60
5) Material and the Quantity mentioned in the order copy in Good Packing condition will only be accepted.
6)Supply of goods along with Invoice in triplicate and invoice must reach accounts dept. PO Total Amount : 64923.60
7)Our PO No shall reflect on your GST Invoice.
8)The material supply if found defective will be replaced by you at your cost. Freight : 0.00
9)All other terms and conditions are applicable as per the approved quotation.
10)This is system generated PO signature not required. Packing & Forwarding : 0.00
11)Ensure your outstanding bill wise amount reconciles with our books, to avoid delay in payments
12)E-invoice with IRN & QR should be a mandatory issue wherever is applicable and the same should reflect in GSTR Installation Charges : 0.00
2A & 2B, otherwise payment will be on Hold.
13)GSTR-1 filing is mandatory on or before 11th of every month, otherwise the GST amount will be on Hold. Labour Charges : 0.00
0.00
Special Terms & Conditions : Unloading Charges :
0.00
PURCHASE ORDER FOR STATIONARY ITEMS TO STATIONARY DEPARTMENT. Insurance Charges :
0.00
Cess :
Delivery Address : Net Value : 64923.60

#32-11-02,Sheela Nagar,VISAKHAPATNAM-500034

Tel No :040 23547532 Fax : 040 23548243

Contact Details for Delivering the Goods :

For Iconkrishi Institute ofMedical Sciences Pvt. Ltd

Authorised Signature
( HOD Purchase )

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