| Name Of the Firm : | Samir Medicine Store |
| Zone : | CENTRAL |
| Range : | Jagatsinghpur |
| Police Station : | |
| Address : | Plot No.778 Khata No.285, W. No.10 AT-Purunagarh PO-Ashrampatna PS-DIST-Jagatsinghpur. |
| RP Name : | Jitendra Kumar Patra |
| Registration Number : | 18699 |
| Competent Person : | |
| Qualification : | D.Pharma |
| Name of the Proprietor : | Sangram Kishore Mohanty |
| R : | 25681 |
| RC : | 25682 |
| RX : | 9898 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 7/19/2010 |
| Date of Expiry : | 7/18/2015 |
| Remarks : |