| Name Of the Firm : | Om Medicine Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 1414, Khata No. 355, At/P.O.- Kabisuryanagar |
| RP Name : | Tiki Ram Nayak |
| Registration Number : | 21682 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Chitta Ranjan Mahapatra |
| R : | SLGAII-4668 |
| RC : | SLGAII-4669 |
| RX : | SLGAII-4670 |
| RR : | |
| RRC : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |