| Name Of the Firm : | Mahanty Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Survey No. 33/3, Plot No. 100, At: Chudia Lanji, P.O.- Samantiapali |
| RP Name : | Sibaram Panda |
| Registration Number : | 12910 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Mina Ketan Mahanty |
| R : | SLGAI-3621 |
| RC : | SLGAI-3622 |
| RX : | SLGAI-3623 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |