| Name Of the Firm : | BANSIDHARI MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT-GOSHALA CHOWK, PO- KALAMATI, DIST- SAMBALPUR |
| RP Name : | SANJAY KUMAR SUBUDDHI |
| Registration Number : | 16102 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | BANSIDHARI MISHRA |
| R : | 1159 |
| RC : | 1160 |
| RX : | 1161 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/6/2002 |
| Date of Expiry : | 11/5/2012 |
| Remarks : | ACR 06.11.2012 TO 05.11.2017 |