| Name Of the Firm : | Sri Balaji Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam I |
| Police Station : | |
| Address : | Plot no-1525,Khatano-27,Asst no-16959,Ram nagar 1st line, Berhampur |
| RP Name : | Sri Jagannath Palo, |
| Registration Number : | 10964(OPC) |
| Competent Person : | |
| Qualification : | D Pharma |
| Name of the Proprietor : | Smt. Monaj Kumar Sabat |
| R : | GAI6104 |
| RC : | GAI6105 |
| RX : | GAI6106 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2011.08.10 |
| Date of Expiry : | 2018.04.14 |
| Remarks : |