| Name Of the Firm : | Maa Tara Tarini Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Holding No. 323, Ward No. 12, At/P.O.- Kabisuryanagar |
| RP Name : | Sanjit Pattnaik |
| Registration Number : | 18713 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Rasal Kumar Dash |
| R : | SLGAII-4898 |
| RC : | SLGAII-4899 |
| RX : | SLGAII-4900 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |