User Details

MANOJ KUMAR
MABA028899F

Father Name MITHOO LAL Mother Name SUNDARI DEVI

Born 11/09/1970 Age 48

manojkhatwani119@gmail.c
Mobile 9412292543 Email
om

ID Type PAN Card ID Number ADWPK1569K

Permanent Address
State Uttar Pradesh District Bareilly

Tehsil Bareilly Address

Flat/House No C 107 RAJENDRA NAGAR Village/Mohalla/Street BAREILLY

Pincode 243001 Nearest Landmark NEAR POLICE CHOWKI

Post Office IZZAT NAGAR Police Station PREM NAGAR

Correspondence Address
State Uttar Pradesh District Bareilly

Tehsil Bareilly Address

Flat/House No C 107 RAJENDRA NAGAR Village/Mohalla/Street BAREILLY

Pincode 243001 Nearest Landmark NEAR POLICE CHOWKI

Post Office IZZAT NAGAR Police Station PREM NAGAR

Firm Detail
Firm Name KISHORE ENTERPRISES

Constitution of Firm Proprietorship Firm

Firm Type Sale

Shop Address & Contact Details

State Uttar Pradesh District Bareilly

Tehsil BAREILLY Address

Shop no./Plot no A1 Name of Market/Building BUTLER PLAZA

Village/Street/Sector BAREILLY Pincode 243001

Post Office HEAD POST OFFICE Police Station KOTWALI

Registered Office, Address & Contact Detail of Firm

State Uttar Pradesh District Bareilly

Tehsil BAREILLY Address

Shop no./Plot no A1 Name of Market/Building BUTLER PLAZA

Village/Street/Sector BAREILLY Pincode 243001

Post Office HEAD POST OFFICE Police Station KOTWALI

Education Details
Degree Board/University Year Class Percentage Highest Degree

Experience Details
DL Issue
Firm Address DL No DL Validity Section Joining Date Leaving Date
Date

Premises Ownership Details

Ownership of
Own Address
Premises/Building

Name MANOJ KUMAR Father Name MITHOO LAL

Registration Date 24/01/2008 Office of registration

Registration Number

Storage Conditions
Carpet Area
51 Furniture Ready Air Conditioner Provided
(Square meter)

Electricity Connection M341911FR2316

Provided 57579 Meter number
Connection Number 0

Electricity Capacity in
Connection Type Commercial
Connection Type Kilowatt

Power Backup Capacity in

Power Backup Provided Inverter 1
Type Kilowatt

Refrigerator Provided Make HAIER Capacity 185

Ceiling -
Serial Number G4498 Floor - Pucca Yes Yes
Pucca/RCC

Partner Details
Responsible for
Name Father Name Address Aadhaar Card Email Mobile day to day
work

Document Details
Category Name Document

Address/ID proof 28899_MABA028899F20181117_044326.jpg

Certificate of Qualifying Eduction 28899_MABA028899F20181117_044402.jpg

High School certificate 28899_MABA028899F20181117_044338.jpg

Proof of building ownership 28899_MABA028899F20181117_044505.jpg

Aadhar Card 28899_MABA028899F20181117_044541.jpg

Photograph of Shop 28899_MABA028899F20181117_044555.jpg

Map of shop 28899_MABA028899F20181117_044528.jpg

FEE CHALAN 28899_MABA028899F20181122_010354.jpg

Competent Person/Pharmacist Details

Unique Id Name Mobile Email Id Address Qualification

License Application Details

Application Application Licence Licence Category of Application Licence Current Payment
Id Date Form Type Drugs Form Fees Status Status

Date: 22/11/2018