| Name Of the Firm : | Maa Ambika Medicine Store |
| Zone : | Central |
| Range : | Jajpur |
| Police Station : | |
| Address : | At. Krushna Nagar, P.O. Sherpur |
| RP Name : | Pitabasha Mallick |
| Registration Number : | 12756 |
| Competent Person : | |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Bhagiratha Acharya |
| R : | 16482 |
| RC : | 16483 |
| RX : | 5457 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/24/2001 |
| Date of Expiry : | 11/23/2016 |
| Remarks : | C/R Recommended |