| Name Of the Firm : | Shree Mandir Medicine Store |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Plot No-3517, kh. No-907, At-Gop, puri |
| RP Name : | Miss Pravasini Senapati |
| Registration Number : | 21166/OPC |
| Competent Person : | - |
| Qualification : | D-Pharma |
| Name of the Proprietor : | Sri Sarat Senapati |
| R : | 25056 |
| RC : | 25057 |
| RX : | 9586 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2/1/2010 |
| Date of Expiry : | 1/31/2015 |
| Remarks : |