Period
____________________________________________________________
Name of Authorised Dealer
________________________________________________
Currency
________________________________________________________
Sl. No.
EXP. NO.
QUANTITY
AMOUNT
CODE
NUMBER
UNIT
UNIT CODE
VOLUME
Cr.
Lac
Th.
Unit
Country
Commodity
TOTAL
Signature and Stamp ofCoded
by: Authorised
DealerChecked
by: Date ..................... ...........