| Name Of the Firm : | BALAJEE MEDICINE STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT/PO- HIRAKUD, DIST- SAMBALPUR |
| RP Name : | PRASANNA KUMAR DAS |
| Registration Number : | 15198 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | PRASANTA KUMAR DORA |
| R : | 1541 |
| RC : | 1542 |
| RX : | 1543 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 1/5/2009 |
| Date of Expiry : | 1/14/2014 |
| Remarks : |