| Name Of the Firm : | Siva Shakti Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Holding No. 12, Ward No. 05, Post Office Road, At/P.O.- Gopalpur On Sea |
| RP Name : | Kabita Rani Patra |
| Registration Number : | 24084 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Jhunu Maharana |
| R : | SLGAI-371 |
| RC : | SLGAI-372 |
| RX : | SLGAI-193 |
| RR : | |
| RRC : | |
| W : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |