| Name Of the Firm : | Sree Ram Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At/Po : Basudevpur, Dist : Bhadrak Plot No.252, Khata No.1229/995 |
| RP Name : | Sri Chandrakanta Das |
| Registration Number : | 11876 (O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Chandrakanta Das. |
| R : | BH-18158/R |
| RC : | BH-18159/RC |
| RX : | BH-5808/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 10/3/2002 |
| Date of Expiry : | 10/2/2017 |
| Remarks : | C/R Not issued |