| Name Of the Firm : | Balaram Medical Store |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | House No- 509, Ward No- 7, At/PO- Heragohiri Sahi, V.I.P. Road Puri |
| RP Name : | Sri E. Braja Mohan Patra |
| Registration Number : | 4060/OPC |
| Competent Person : | - |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Sri E. Braja Mohan Patra |
| R : | 8299 |
| RC : | 8300 |
| RX : | 1443 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 12/4/1989 |
| Date of Expiry : | 12/31/2017 |
| Remarks : |