| Name Of the Firm : | Khetrapali Medicine Store, |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Plot No- 46, Kh. No- 09, At- Teisipur, Dist-Puri |
| RP Name : | Sri Lalit Ku Das |
| Registration Number : | 24294/OPC |
| Competent Person : | - |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Sri Ajaya Narayan Mohapatra |
| R : | 24400 |
| RC : | 24401 |
| RX : | 9259 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2/16/2009 |
| Date of Expiry : | 2/15/2014 |
| Remarks : |