| Name Of the Firm : | Maa Basanti Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At /Po : Bhandaripokhari, Dist:Bhadrak Plot No.1964, Khata No.559 |
| RP Name : | Sri Pradip Ku. Tripathy |
| Registration Number : | 15051(O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Sri Pradip Ku. Tripathy. |
| R : | BH-22207/R |
| RC : | BH-22208/RC |
| RX : | BH-8166/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 8/11/2006 |
| Date of Expiry : | 8/10/2016 |
| Remarks : | C/R Not Issued |