| Name Of the Firm : | Susila Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam II Range |
| Police Station : | |
| Address : | Ward No. 06, Holding No. 873, At/P.O.- Chikiti Pentho |
| RP Name : | Sadananda Sahu |
| Registration Number : | 4028 |
| Competent Person : | |
| Qualification : | D. Pharma |
| Name of the Proprietor : | Sadananda Sahu |
| R : | GA-7576 |
| RC : | GA-7577 |
| RX : | GA-1994 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | |
| Date of Expiry : | |
| Remarks : |