| Name Of the Firm : | BALAJI MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | DHANUPALI CHOWK, SAMBALPUR |
| RP Name : | PRATAP KISHOR MISHRA |
| Registration Number : | 1038 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | SUSHIL KU JHAJHRIA |
| R : | 1101 |
| RC : | 1102 |
| RX : | 1103 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/29/2005 |
| Date of Expiry : | 11/28/2010 |
| Remarks : | ACR 29.11.2010 TO 18.11.2015 |