| Name Of the Firm : | Maa Bhairabi Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 1214, Khata No. 290, Ganesh Road, At/P.O.- Randha |
| RP Name : | Debaraj Panda |
| Registration Number : | 1727 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Gouri Sahu |
| R : | SLGAI-2895 |
| RC : | SLGAI-2896 |
| RX : | SLGAI-2897 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |