| Name Of the Firm : | Dipa Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Khata No. 411, Survey No. 618/3295, At: Surla Road Junction, P.O.- Girisola |
| RP Name : | Krishna Chandra Shau |
| Registration Number : | 7423 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Krishna Chandra Shau |
| R : | SLGAI-503 |
| RC : | SLGAI-504 |
| RX : | SLGAI-257 |
| RR : | |
| RRC : | |
| W : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |