Account No: 1013070783 Invoice No: WDCGJ2220355607

Invoice Date: 04/08/2022 Billing Period

01/07/2022 to 31/07/2022

Tariff Plan: SULAB-H

Bill Mail Service Tax Invoice

Dr. HITENDRA PRAHLADBHAI
TELEPHONE NUMBER DUE DATE
PATEL .
20-08-2022
C/O DIVYA ORTHOPAEDIC 02762-232073
HOSPITAL AMOUNT PAYABLE
UMIYA CHAMBERS OPP SWAMI
NARAYAN TEMPLE MEHSANA GSTIN R 478.00
MEHSANA RADHANPUR CROSS Scan QR Code to make online
ROAD MEHSANA-2 Portal Payment
MEHSANA IN
PAY NOW
384002
India
ACCOUNT SUMMARY Deposit Amount: 1299.00
PREVIOUS BALANCE PAYMENT RECEIVED ADJUSTMENTS CURRENT CHARGES TOTAL DUE AMOUNT PAYABLE
{nNbr am{e (-) nyd© ^wJVmZ (+) g_m`moOZ (+) dV©_mZ ewëH (=) Hwb ~Mo (=) Xo` am{e
R 176.44 R 177.00 R 250.00 R 227.72 R 477.16 R 478.00
Amount in Words: Rupees Four Hundred Seventy Eight and Zero Only

SUMMARY CHARGES USAGE HISTORY (6 MONTHS) Voice(Min)

Current Charges dV©_mZ ewëH {ddaU Amount R Data(GB)
Recurring Charges nwZamdVu ewëH 154.84
One Time Charges EH ~ma ewëH 0.00
5 Min 5 GB
Usage Charges Cn`moJ n«^ma 0.00
Miscellaneous Charges {d{dY n«^ma 0.00 4 Min 4 GB

Discount NzQ 0.00

3 Min 3 GB
Tax Ha 72.88
Total Current Charges dV©_mZ exëH 227.72 2 Min 2 GB

Tax Details
1 Min 1 GB
Tax Type Percentage Amount Taxable Value
CGST 9.00% 36.44 404.84
SGST/UTGST 9.00% 36.44 404.84 0 Min 0 GB
Jan'22 Feb'22 Mar'22 Apr'22 May'22 Jun'22
6 Paisa Cash Back Offer Amount 0.00

Dear Customer, Income Tax Department, Govt of India has granted certificate no. 197(1)/AABCB5576G/2022-23/1 Dt 22/06/2022 (can be downloaded from
https://bsnl.co.in/opencms/bsnl/BSNL/about_us/pdf/Certificate_197AABC_2022.pdf) to BSNL relating to TDS at lower rates applicable from 22/06/2022 to
31/03/2023. TDS may be recovered at the lower rates mentioned in the certificate issued by Income Tax Department.

KIRAN B CHAVDA
boIm A{YH mar
For Billing related issues
02762-252542

Scan QR Code to make UPI Payment

Dear Customer, We recommend you to pay the bill online using https://portal.bsnl.in/ or use My BSNL App on your mobile to avail our services 24*7.
My BSNL App is available on the Google Play Store. #Unite2FightCorona.

- PAYMENT SLIP - Invoice No WDCGJ2220355607

BHARAT SANCHAR NIGAM LTD Mode of Payment Invoice Date 04/08/2022

Cash Cheque/DD Credit/Debit Card Account No 1013070783

Phone No 02762-232073
Cheque/DD No. Dated Bank Branch
Due Date 20-08-2022
Please Charge Rs. Signature Amount Payable R 478.00

Please make crossed Cheque/DD/Pay Order for Amount Payable (Rounded Up) in favour of AO (Cash), BSNL, MEHSANA. For Bank use only
This is a Computer generated Bill and does not require any Signature. Page 1 of 3
Account No:1013070783 | Invoice No:WDCGJ2220355607 | Invoice date:04/08/2022

WAYS TO PAY BILL

For online payment, log on to www.bsnl.co.in or Pay through My BSNL App.
Scan any QR Code on the bill Download My BSNL App to avail BSNL
services & making bill payments

Pay at any BSNL Customer Service

Pay at any Post Office on or before Due Date
Center (CSC's)

Drop your Cheque / DD at BSNL bill

Pay at any BSNL Retailer Outlet collection center

Pay your bill in time and save on late fee charges of 2% of billed amount (Min. Rs.10/-)

CUSTOMER CARE
l Dial Toll Free Number 1500 for (Landline/Broadband) from BSNL Numbers and 1800-345-1500 from all other Service Provider Numbers
l Dial Toll Free Number 1503 for (Mobile) from BSNL Numbers and 1800-180-1503 from all other Service Provider Numbers
l Dial 198 from BSNL numbers for Automatic Fault Booking
l Log on to web selfcare portal www.selfcare.bsnl.co.in
l Download My BSNL App to avail BSNL services & making bill payments

For Service related issues :- JASVANTSINH THAKOR, 02762-240800

CUSTOMER INFORMATION

l Get the last bill details on your mobile, SMS BILL <Space><STDCODE-TEL.NO><Space><BILLING ACCOUNT NO> on 53334 from
nnnBSNL mobile and for Non BSNL Mobile on 9478053334
l Log on to www.bsnl.co.in for information on the tariff plans and prices
l For change of billing address, please contact your nearest customer care or AO (TR) / Commercial Officer of your exchange area
l If your mobile/landline is used for sending unsolicited commercial communication (UCC) through SMS or Voice, it leads to disconnection
nnnof your telecom resources and blacklisting for two years
l For contact details of Nodal Officer / Appellate Authority, tariffs and other information, visit our website www.bsnl.co.in
l Disputes if any, should be brought to the notice of concerned AO(TR) within 60 days

Supplier's Address: AGM PC, GM(Telecom) Ahmedabad Telecom, l GST Registration Number :24AABCB5576G1ZR l PAN Number:AABCB5576G
Admn Bldg, Gujarat Circle, Opp. Tulsi Vihar Society, l HSN/SAC Code:998412 l CIN:U74899DL2000GOI107739
Khanpur-380001, Gujarat

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 Account No:1013070783 | Invoice No:WDCGJ2220355607 | Invoice date:04/08/2022

DETAILS OF CURRENT CHARGES CURRENT CHARGE ANALYSIS

Payment Details
Description Date of Payment Amount(Rs.) r 154.84
Payments 11/07/22 177.00

Adjustment
Adjustment Description Charges (Rs.)
Shift-Charges -SAC-998412 250.00
Total Charges (Rs.) 250.00

Plan : SULAB-H /
r 250.00 r 72.88

Recurring Charges Recurring charges Usage Charges

One Time Charges Adjustments
Product Plan Period Charges(Rs.)
Miscellaneous Charges Tax
LANDLINE-SAC-998412 SULAB-H 01/07/22 to 30/07/22 145.16
LANDLINE-SAC-998412 SULAB-H 30/07/22 to 31/07/22 9.68
Total Recurring Charges 154.84

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