| Name Of the Firm : | Sri Jagannath Medical Store, |
| Zone : | S/Z |
| Range : | PKD |
| Police Station : | |
| Address : | At/Po Chheligada, P. no- 876, K no- 22 |
| RP Name : | Smt.Soudamini Prusty R.No-9034/OPC |
| Registration Number : | R.No-9034/OPC |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | Ramkrushna Mohapatra (Prop.) |
| R : | 2148 |
| RC : | 2149 |
| RX : | 2150 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 8/29/2003 |
| Date of Expiry : | 30.06.19 |
| Remarks : |