| Name Of the Firm : | Surya Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Plot No. 375, Khata No. 148, At/P.O.- Burupada |
| RP Name : | Surya narayan Tripathy |
| Registration Number : | 10831 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Surya narayan Tripathy |
| R : | SLGAII-4110 |
| RC : | SLGAII-4111 |
| RX : | SLGAII-4112 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |