Date of Receipt______________
Delivery Challan / Invoice No.:__________________________Dated:______________
Name & Address of Supplier:__________________________________________________
________________________________________________________________________
Name of items mentioned in Delivery challan / Invoice (D / C / Inv.)
1. _______________________________
2. _______________________________
3. _______________________________
1.0 Check the following
(a) Whether total number of containers mentioned in (State total No. of DC / Inv. tallies with the containers) number of containers received?
Name of Number of
items containers
_____________ __________
c) Do the following particulars on label of containers and DC / Inv. tally?
i) Name of item. Yes / No
ii) Name of Manufacturer Yes / No
iii) Batch No Yes / No
iv) Date of Exp. if any Yes / No

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