| Name Of the Firm : | Jai Sriram Medical Store, |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Plot NO-112, Kh.No-416, At/po- Sakhigopal,Puri |
| RP Name : | Sri Ashirbad Nayak |
| Registration Number : | 21379/OPC |
| Competent Person : | - |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Smt. Sasmita Mishra |
| R : | 12430 |
| RC : | 12431 |
| RX : | 3431 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/20/1996 |
| Date of Expiry : | 12/31/2016 |
| Remarks : |