| Name Of the Firm : | Maa Tara Tarini Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Survey No. 1768, Khata No. 228, At/P.O.- Pitatali |
| RP Name : | Sangram Keshari Pattnaik |
| Registration Number : | 5205 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Sangram Keshari Pattnaik |
| R : | SLGAI-4107 |
| RC : | SLGAI-4108 |
| RX : | SLGAI-4109 |
| RR : | |
| RRC : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |