| Name Of the Firm : | SIVA MEDICAL STORE |
| Zone : | Western Zone, Sambalpur |
| Range : | Sambalpur |
| Police Station : | |
| Address : | AT/PO- MANESWAR, DIST- SAMBALPUR |
| RP Name : | S.PURNIMA |
| Registration Number : | 6944 |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | SMT.S.RAJ KUMARI |
| R : | 191 |
| RC : | 192 |
| RX : | |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 4/1/2009 |
| Date of Expiry : | 3/31/2014 |
| Remarks : |