| Name Of the Firm : | OM SAI- SANJIVANI MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | DHANKAUDA, SAMBALPUR |
| RP Name : | PURNA CHANDRA SAHU |
| Registration Number : | 1678 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | PRAMOD KUMAR MISHRA |
| R : | 1565 |
| RC : | 1566 |
| RX : | 1567 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 6/2/2009 |
| Date of Expiry : | 6/1/2014 |
| Remarks : |