| Name Of the Firm : | SHIVANI MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | JAIL CHOWK, SAMBALPUR |
| RP Name : | DEEPTI MAYEE SAHU |
| Registration Number : | 15491 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | RABINDRA NATH PANIGRAHI |
| R : | 1631 |
| RC : | 1632 |
| RX : | 1633 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 11/10/2010 |
| Date of Expiry : | 11/9/2015 |
| Remarks : |