| Name Of the Firm : | Sri Santiswar Medicine Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 1114, Khata No. 488/26, At/P.O.- Girisola |
| RP Name : | Ranjit Kumar Mahanty |
| Registration Number : | 15277 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Trinath Sahu |
| R : | SLGAI-2136 |
| RC : | SLGAI-2137 |
| RX : | SLGAI-2138 |
| RR : | |
| RRC : | |
| W : | |
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| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |