| Name Of the Firm : | Maa Ambika Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At : Balipokhari, Po : Anijo, Dist : Bhadrak Plot No.237, Khata No.178 |
| RP Name : | Sri Naba Kishore Das |
| Registration Number : | 11024(O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Naba Kishore Das . |
| R : | BH-22734/R |
| RC : | BH-22735/RC |
| RX : | BH-8435/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 4/18/2007 |
| Date of Expiry : | 4/17/2017 |
| Remarks : | C/R Not Issued |