Name Of the Firm :	Basanta Medical & General Store
Zone :	Southern Zone
Range :	Ganjam II Range
Police Station :
Address :	Plot No. 1094/32, House No. 204, Khata No. 737, Ward No. 11, At/P.O.- Surala
RP Name :	Simanchala Dakua
Registration Number :	6841
Competent Person :
Qualification :	D. Pharma
Name of the Proprietor :	Kedarnath Behera
R :	SLGAI-487
RC :	SLGAI-488
RX :	SLGAI-250
RR :
RRC :
W :
WC :
WX :
Date of Issue :
Date of Expiry :
Remarks :