| Name Of the Firm : | Sibam Medical Store |
| Zone : | South Zone |
| Range : | Nuapada |
| Police Station : | |
| Address : | Plot No- 1215, Khata No- 110, At- Dhungiamunda, po- Kendumunda |
| RP Name : | Ashok Kumar Taria |
| Registration Number : | 21541 |
| Competent Person : | |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Bhrungraj Nag |
| R : | SL-NU-5198R |
| RC : | SL-NU-5199Rc |
| RX : | SL-NU-5200Rx |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2/26/2010 |
| Date of Expiry : | 2/25/2015 |
| Remarks : |