Name Of the Firm :	CHAMPA MEDICAL STORE
Zone :	Western Zone, Sambalpur
Range :	Sambalpur
Police Station :
Address :	AT-THELKOLI, PO- LAPANGA, DIST- SAMBALPUR
RP Name :	MISS PRABINA DEHURY
Registration Number :	18836
Competent Person :
Qualification :
Name of the Proprietor :	ASHOK KU CHANDAN
R :	1505
RC :	1506
RX :	1507
RR :
RRC :
W :
WC :
WX :
Date of Issue :	8/28/2008
Date of Expiry :	8/21/2013
Remarks :