| Name Of the Firm : | Siba Shankara Medical & General Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 3178, Khata No. 1119/357, Survey No. 3178/10248, Hoolding No. 1227, At/P.O.- Digapahandi |
| RP Name : | Rajendra Behera |
| Registration Number : | 9284 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Promod Kumar Panigrahi |
| R : | SLGAI-409 |
| RC : | SLGAI-410 |
| RX : | SLGAI-211 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |