| Name Of the Firm : | Basuli Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At : Kuanshmadia, Po : B.T. Pur Dist : Bhadrak Plot No.2189, Khata No.928/344 |
| RP Name : | Sri Pravas Ranjan Sahu |
| Registration Number : | 9726(O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Santosh Ku. Jena . |
| R : | BH-18754/R |
| RC : | BH-18755/RC |
| RX : | BH-6100/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 5/1/2003 |
| Date of Expiry : | 2013-04-31 |
| Remarks : | C/R Not Issued |