| Name Of the Firm : | OM MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT/PO- BURLA, DIST- SAMBALPUR |
| RP Name : | GOPAL KRISHNA DASH |
| Registration Number : | 13999 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | GOPAL KRISHNA DASH |
| R : | 1257 |
| RC : | 1258 |
| RX : | 1259 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 6/25/2004 |
| Date of Expiry : | 6/24/2014 |
| Remarks : |