Date of issue(Figures): 
Date of issue(Words): 
Time of commencement  hrs/mins
Place from which goods are consigned: 
Description,Quantity and Value:

sl no	Item commodity	Invoice number	Quantity	Value of goods(figures)	Value of goods(words)
1.
2.
3.

Name, Address of the owner of the vehicle by which goods are cosigned
Name & Address Vehicle Number