| Name Of the Firm : | Madhaba Medicine Store |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Mangalpur P.H.C Campus, Dist-Puri |
| RP Name : | 1 Madhab Das 2 Sri Pravat Ku Mangaraj |
| Registration Number : | 15715 /OPC 10220 /OPC |
| Competent Person : | - |
| Qualification : | D.pharma |
| Name of the Proprietor : | Sri Madhaba Das |
| R : | 25891 |
| RC : | 25892 |
| RX : | 9973 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/3/2010 |
| Date of Expiry : | 11/2/2015 |
| Remarks : |