| Name Of the Firm : | JAI MATADI MEDICLA & GENERAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT-THELKOLI, PO- LAPANGA, DIST- SAMBALPUR |
| RP Name : | GOPAL PRASHAD AGRAWAL |
| Registration Number : | 8601 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | BIHARI PRASAD AGRAWAL |
| R : | 1404 |
| RC : | 1405 |
| RX : | 1406 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/29/2011 |
| Date of Expiry : | 11/28/2016 |
| Remarks : | CHANGE OF PROP. W.E.F 29.11.2011 |