| Name Of the Firm : | Jayadurga Medical Store |
| Zone : | South Zone |
| Range : | Kalahandi |
| Police Station : | |
| Address : | Plot No.-524, Khata No.-180, Mohangiri, Kalahandi |
| RP Name : | Smt. Basanti Nayak |
| Registration Number : | 10968 |
| Competent Person : | - |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Pitambar Sahu |
| R : | 4134 |
| RC : | 4135 |
| RX : | 4136 |
| RR : | - |
| RRC : | - |
| W : | - |
| WC : | - |
| WX : | - |
| Date of Issue : | 2/14/2008 |
| Date of Expiry : | 2/13/2018 |
| Remarks : | Applied for C/R |