| Name Of the Firm : | Jeeban Dhara Medicine Store |
| Zone : | Central |
| Range : | Jajpur |
| Police Station : | |
| Address : | At/P.O.- Dharmasala |
| RP Name : | Mrutyunjaya Padhi |
| Registration Number : | 18564 |
| Competent Person : | |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Debadutta Nayak |
| R : | 24218 |
| RC : | 24219 |
| RX : | 9168 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/11/2008 |
| Date of Expiry : | 11/10/2013 |
| Remarks : |