Name Of the Firm :	Basanta Medical Hall
Zone :	CENTRAL
Range :	Khordha
Police Station :
Address :	Plot No 114/3340, Kh. No- 648/1666, Mouza- Jajarsingh, Khurda
RP Name :	Smt Santwana Mohanty
Registration Number :	18258/OPC
Competent Person :
Qualification :	D. Pharma
Name of the Proprietor :	Sri Prafulla Kumar Rath
R :	KH 23104
RC :	KH 23105
RX :	KH 8619
RR :
RRC :
W :
WC :
WX :
Date of Issue :	10/6/2007
Date of Expiry :	10/5/2012
Remarks :	Send to D.C.O vide letter No. 918/30.08.2012 1200/05.12.2012 (applied for change of RP from 24-07-2012 renewal for 06-10-12 to 05-10-17)