| Name Of the Firm : | Sri Venketeswar Medical Store, |
| Zone : | S/Z |
| Range : | PKD |
| Police Station : | |
| Address : | At/Po-Garabandha, P.no- 113/580, K. no- 40/251 |
| RP Name : | Prasanta Kumar Panda Regd.No-14887/OPC |
| Registration Number : | Regd.No-14887/OPC |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | Savdiri Santa Rao (Prop.) |
| R : | 1578 |
| RC : | 1579 |
| RX : | 1580 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2003 |
| Date of Expiry : | 15.03.18 |
| Remarks : |