| Name Of the Firm : | Maa Mangala Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam I |
| Police Station : | |
| Address : | Plot no-1188/3573,Khata no-1030/1240,Ground floor,Ananta Nagar,Berhampur |
| RP Name : | Smt.Usharani Panda |
| Registration Number : | 10686 |
| Competent Person : | |
| Qualification : | B Pharma |
| Name of the Proprietor : | Sri Simanchala Panda |
| R : | GAI527 |
| RC : | GAI528 |
| RX : | GAI269 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 1999.12.02 |
| Date of Expiry : | 31.12.2017 |
| Remarks : |