| Name Of the Firm : | Maa Medicine Store, |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | H.No-765,At-Goudabada Sahi,Puri |
| RP Name : | Radhashyam Mohapatra |
| Registration Number : | 2983/OPC |
| Competent Person : | - |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Smt.Nirupama Mohapatra |
| R : | 11556 |
| RC : | 11557 |
| RX : | 2996 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 8/26/1995 |
| Date of Expiry : | 12/31/2017 |
| Remarks : |