| Name Of the Firm : | Baishno Devi Medical Store, |
| Zone : | Southern Zone |
| Range : | Ganjam I |
| Police Station : | |
| Address : | Plot No. 961/4632,Khata No. 1166/1149,Doctor Lane, New Bus Stand,Berhampur |
| RP Name : | Smt.Mamata Patro |
| Registration Number : | 8997 (OPC) |
| Competent Person : | |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Smt.Sasmita Mangaraj |
| R : | GAI 5156 |
| RC : | GAI 5157 |
| RX : | GAI 5158 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2/4/2010 |
| Date of Expiry : | 2/3/2015 |
| Remarks : |