| Name Of the Firm : | Basanti Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At : Jashipur, P.O : Kuda, Dist : Bhadrak Plot No. 607/1494, Khata No. 236/111 |
| RP Name : | Sri Kisan Kumar Rout |
| Registration Number : | 8621 (O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Jayanta Rout |
| R : | BH-27801/R |
| RC : | BH-27802/RC |
| RX : | BH-10913/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 10/25/2012 |
| Date of Expiry : | 10/24/2017 |
| Remarks : | Up to dated Licence |