| Name Of the Firm : | Basanti Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At:Barikchhak, Po:Ichhapur, Dist:Bhadrak Plot No.1855, Khata No.417 |
| RP Name : | Nargish Yasmin Fatmah |
| Registration Number : | 13816(O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Satya Narayan Jena |
| R : | BH-24616/R |
| RC : | BH-24617/RC |
| RX : | BH-9269/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 6/1/2009 |
| Date of Expiry : | 5/31/2014 |
| Remarks : | Up to date licence |