| Name Of the Firm : | MAA SAMALESWARI MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT-GUMKARAMA, PO-GHICHAMURA, DIST-SAMBALPUR |
| RP Name : | PANCHANAN RAY |
| Registration Number : | 11111 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | PANCHANAN RAY |
| R : | 1383 |
| RC : | 1384 |
| RX : | 1385 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 7/31/2006 |
| Date of Expiry : | 7/30/2016 |
| Remarks : |