| Name Of the Firm : | Jaya Maa Mangala Drug House |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 180, Khata No. 35, At: Chandrama Dei Pur, P.O.- Hatiota |
| RP Name : | Sunil Kumar Dash |
| Registration Number : | 15261 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Sunil Kumar Dash |
| R : | SLGAII-2886 |
| RC : | SLGAII-2887 |
| RX : | SLGAII-2888 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |