| Name Of the Firm : | Mamta Medical Store, |
| Zone : | Central |
| Range : | Puri |
| Police Station : | |
| Address : | Plot No- 472, Kh. No-127, At/Po- Rebenanuagaon,puri |
| RP Name : | Sri Anukula Chandra Pati |
| Registration Number : | 15017 /OPC |
| Competent Person : | - |
| Qualification : | D.pharma |
| Name of the Proprietor : | Sri Malaya ku. Das |
| R : | 11862 |
| RC : | 11863 |
| RX : | 3150 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2/6/1996 |
| Date of Expiry : | 12/31/2016 |
| Remarks : |