| Name Of the Firm : | Jaya Maa Sidheswari Medical Store, |
| Zone : | S/Z |
| Range : | PKD |
| Police Station : | |
| Address : | At/po- Anukundagada, (5 Mile), Po- Pkd, P no- 338/1920, k no- 361/425 |
| RP Name : | Sri. Debananda Mishra Regd No.- 24632/Opc |
| Registration Number : | Regd No.- 24632/Opc |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | Sri Niranjan Kumar Sundar Rae Patra |
| R : | 5910 |
| RC : | 5911 |
| RX : | 5912 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 3/23/2011 |
| Date of Expiry : | 3/22/2016 |
| Remarks : |