| Name Of the Firm : | Shree Basudev Medicine Store, |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Plot No-990,Kh. No- 605, Rench Sasan,Ps-Nimapara,Puri |
| RP Name : | Sahazad uddin Ahemed |
| Registration Number : | 24068/OPC |
| Competent Person : | - |
| Qualification : | D-Pharma |
| Name of the Proprietor : | Sri Susil Kumar Hota |
| R : | 23764 |
| RC : | 23765 |
| RX : | |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 7/11/2008 |
| Date of Expiry : | 7/10/2013 |
| Remarks : |