| Name Of the Firm : | Maa Balakumari Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Survey No. 180, Khata No. 16, At: Dhanaghara, P.O.- Ramachandra Pur |
| RP Name : | Brundaban Pradhan |
| Registration Number : | 5354 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Brundaban Pradhan |
| R : | SLGAI-571 |
| RC : | SLGAI-572 |
| RX : | SLGAI-291 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |