| Name Of the Firm : | Ambica Medical Store, |
| Zone : | Southern Zone |
| Range : | Ganjam I |
| Police Station : | |
| Address : | Asst.No. 8829(A),Ward.No. 13,Hanuman Bazar,Berhampu |
| RP Name : | Prasant Kumar Patro |
| Registration Number : | 20748(OPC) |
| Competent Person : | |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Sri K.Ramesh |
| R : | GAI-213 |
| RC : | GAI-214 |
| RX : | GAI-215 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 7/10/2003 |
| Date of Expiry : | 1/31/2018 |
| Remarks : |