| Name Of the Firm : | Sri Devi Medicine & General Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 808, Khata no. 862, Ward No. 09, At: Pathara, P.O.- Bahadurpetha |
| RP Name : | S. Nageswar Prusty |
| Registration Number : | 8926 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | A. Ram Babu Patro |
| R : | SLGAI-361 |
| RC : | SLGAI-362 |
| RX : | SLGAI-189 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |